Individual provider Active NPI

Brianna Kristen Ennis, MD

  • Pediatrics Physician
  • Oakland, CA
National Provider Identifier
1013386630
Registry record updated Nov 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
178770 Issued in CA
Practice address
6955 Foothill Blvd Ste 200
Oakland, CA 94605-2426
Phone
(510) 437-8500
NPI assigned
Sep 24, 2015
Last updated
Nov 17, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 178770 CA Primary

Addresses

Primary practice location

6955 Foothill Blvd Ste 200
Oakland, CA 94605-2426

Mailing address

747 52ND St
Oakland, CA 94609-1809
Phone (510) 428-3331

Other practice location 1

747 52nd St
Oakland, CA 94609-1809
Phone (510) 428-3331

Other practice location 2

2000 Outlet Center Dr Ste 110
Oxnard, CA 93036-0608
Phone (805) 604-4588

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address brianna.ennis@ventura.cernerdirect.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250314002167 CA Practitioner - Pediatric Medicine 6002338431 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
178770CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Ventura CurrentSince Feb 1, 2025 Accepting new patients
County of Ventura CurrentSince Feb 1, 2025 Accepting new patients
County of Ventura Current Accepting new patients

Locations

2000 Outlet Center Dr
Ste 110
Oxnard, CA 93036
Phone (805) 604-4558

300 Hillmont Ave
Ventura, CA 93003
Phone (805) 652-6000

800 S Victoria Ave
#L4640
Ventura, CA 93009

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1443052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763337600000",
    "number": "1013386630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "747 52ND ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946091809",
            "telephone_number": "510-428-3331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6955 FOOTHILL BLVD STE 200",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946052426",
            "telephone_number": "510-437-8500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "747 52nd St",
            "address_purpose": "LOCATION",
            "city": "Oakland",
            "state": "CA",
            "postal_code": "946091809",
            "country_code": "US",
            "telephone_number": "510-428-3331",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2000 Outlet Center Dr Ste 110",
            "address_purpose": "LOCATION",
            "city": "Oxnard",
            "state": "CA",
            "postal_code": "930360608",
            "country_code": "US",
            "telephone_number": "805-604-4588",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ENNIS",
        "first_name": "BRIANNA",
        "middle_name": "KRISTEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-24",
        "last_updated": "2025-11-17",
        "certification_date": "2025-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "178770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "brianna.ennis@ventura.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "Cerner Direct Secure Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Information",
            "address_1": "2000 Outlet Center Dr Ste 110",
            "city": "Oxnard",
            "state": "CA",
            "country_code": "US",
            "postal_code": "930360608",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.