JENNY TA PETTERSEN (NPI# 1780016097) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780016097 |
| Entity Type | Individual |
| Full Name | JENNY TA PETTERSEN |
| Credential | FNP |
| Practice Address |
818 Webster St Oakland CA 94607-4220 |
| Practice Telephone | 5109866800 |
| Mailing Telephone | 5109866800 |
| Enumeration Date | 2013-08-08 |
| Last Update Date | 2017-04-09 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | 757451 | CA | Nursing Service Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
23448 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
818 WEBSTER ST |
| City | OAKLAND |
| State | CA |
| Zip Code | 94607-4220 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609845767 | Yee-bun B Lui | Internal Medicine | 818 Webster St, Oakland, CA 94607-4220 | 2006-03-14 |
| 1285234195 | Tammy Vien | Registered Nurse | 818 Webster St, Oakland, CA 94607-4220 | 2020-10-29 |
| 1013514470 | Shanshan Zhao | Registered Nurse | 818 Webster St, Oakland, CA 94607-4220 | 2020-10-07 |
| 1730725540 | Shuyu Li | Registered Nurse | 818 Webster St, Oakland, CA 94607-4220 | 2019-11-27 |
| 1477195717 | Yan Cai | Licensed Vocational Nurse | 818 Webster St, Oakland, CA 94607-4220 | 2019-10-08 |
| 1912556358 | Linda Shuk Ching Tang | Registered Nurse | 818 Webster St, Oakland, CA 94607-4220 | 2019-09-09 |
| 1629627310 | Connie Shin Man Chiu | Registered Nurse | 818 Webster St, Oakland, CA 94607-4220 | 2019-09-05 |
| 1972152726 | Kelly Jia Li Fang | Registered Nurse | 818 Webster St, Oakland, CA 94607-4220 | 2019-09-04 |
| 1760030803 | Kimberly Chee | Registered Nurse | 818 Webster St, Oakland, CA 94607-4220 | 2019-09-02 |
| 1245888312 | Sui Kei Lam Tang | Registered Nurse | 818 Webster St, Oakland, CA 94607-4220 | 2019-08-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851990832 | Casey Domine | Nurse Practitioner | 1750 10th St., Apt. A, Oakland, CA 94607 | 2020-10-21 |
| 1992303226 | Sonia Maria Sui Ying Poon Harris | Pharmacist | 388 9th Street Ste 108, Oakland, CA 94607 | 2020-10-09 |
| 1962029595 | Yuan Yan | Student in an Organized Health Care Education/Training Program | 310 8th Street, Suit 210 Asian Health Services: Special, Oakland, CA 94607 | 2020-06-30 |
| 1093339962 | Alameda County Probation Department | Case Manager/Care Coordinator | 1111 Jackson St., Oakland, CA 94607 | 2020-06-05 |
| 1053947812 | Deanna Karraa | Registered Nurse | 1111 Jackson 6th Floor, Oakland, CA 94607 | 2020-03-12 |
| 1952942575 | Roots Community Health Center | Family Medicine | 583 5th St Ste A, Oakland, CA 94607 | 2019-10-04 |
| 1568927994 | Lynsey Scott | Counselor | Wiley Manuel Courthouse, 661 Washington St Rm223, Oakland, CA 94607 | 2019-02-11 |
| 1366930182 | Options Recovery Services | Community/Behavioral Health | 614 Alice St, Oakland, CA 94607 | 2018-04-26 |
| 1255845640 | Adrienne My-tram Nguyen, Dds - Inc | Dentist | 475 8th Street, Oakland, CA 94607 | 2017-11-22 |
| 1912422528 | Maria H Cho | Registered Nurse | 2511 Market St, Oakland, CA 94607 | 2017-08-04 |
| Find all providers in zip 94607 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639777386 | Jonathan Josue Grijalva | Nurse Practitioner | 1909 White Feather Loop, Oakland, FL 34787-8127 | 2020-10-14 |
| 1790313047 | Macy Sun | Nurse Practitioner | 1806 9th Ave, Oakland, CA 94606-3020 | 2020-03-31 |
| 1073157756 | Theola J Rivera | Nurse Practitioner | 889 Wynstone Cir N, Oakland, MI 48363-1605 | 2019-11-05 |
| 1326692211 | Shanna Lee | Nurse Practitioner | 35 Buena Vista Pl, Oakland, CA 94618-2132 | 2019-07-29 |
| 1184287682 | Kristine Dionne Williams | Nurse Practitioner | 3847 Rhoda Ave, Oakland, CA 94602-3322 | 2019-04-19 |
| 1346702404 | Whitney Karr | Nurse Practitioner | 65 Thousand Oaks St, Oakland, CA 94605-4618 | 2019-04-05 |
| 1982104360 | Brandi Sue Paugh | Nurse Practitioner | 241 N 4th St, Oakland, MD 21550-1375 | 2018-02-13 |
| 1164930533 | Brookside Health & Wellness LLC | Nurse Practitioner | 6500 Thayer Center, Oakland, MD 21550-1116 | 2018-01-18 |
| 1356870315 | Ayelet Cohen | Nurse Practitioner | 333 Park View Ter Apt 2, Oakland, CA 94610-4646 | 2017-06-05 |
| 1679014534 | Priscilla Beach Brown | Nurse Practitioner | 138 Monte Cresta Ave Apt 206, Oakland, CA 94611-4805 | 2017-03-12 |
| Find all providers in OAKLAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.