Elsa Petronella Van Berry, CRYT, RN, MSN,FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2011003399 Issued in CA

Practice address

3100 Summit St FL 2
Oakland, CA 94609-3412

Phone

(510) 869-8865

Fax

(510) 869-6271

NPI assigned

Oct 28, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

Interoperability endpoints

• Direct secure messaging: pvanberry385028@hisp.ehr.sutterhealth.org

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

{
    "created_epoch": "1382918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513036800000",
    "number": "1083042162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3687 MT DIABLO BLVD STE 200",
            "city": "LAFAYETTE",
            "state": "CA",
            "postal_code": "945493746",
            "telephone_number": "510-204-6660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 SUMMIT ST FL 2",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093412",
            "telephone_number": "510-869-8865",
            "fax_number": "510-869-6271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN BERRY",
        "first_name": "ELSA PETRONELLA",
        "credential": "CRYT, RN, MSN,FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-28",
        "last_updated": "2017-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "2011003399",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER #",
            "identifier": "55-1876",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Khanh-Van Yveline Van Anh
• Hendrik K Van Antwerpen, MFTI, M.S.
• Heather L Van Atta
• Clay Van Batenburg, LCSW
• Daniel Sebastien Van Beek, B.A.
• Sonia Van Braden, CNM
• Kimberly Anne Van Buskirk
• Erica Van Den Haak, MD
• Hendrika Wilhelmina Van Den Herik, PT
• Masja Van Der Hoog, MSOM, L.AC

• Family Nurse Practitioner in Oakland, CA
• Providers in Oakland, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.