Individual provider Active NPI

Annie Rose Palmer, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Berkeley, CA
National Provider Identifier
1083169064
Registry record updated May 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
21227 Issued in CA
Practice address
2640 Martin Luther King Jr Way
Berkeley, CA 94704-3238
Phone
(510) 981-5290
Fax
(510) 981-5265
NPI assigned
Aug 19, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 21227 CA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 21227 CA Primary

Addresses

Primary practice location

2640 Martin Luther King Jr Way
Berkeley, CA 94704-3238

Mailing address

2640 Martin Luther King Jr Way
Berkeley, CA 94704-3238
Phone (510) 981-5290

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161220001571 CA Practitioner - Nurse Practitioner 1355622929 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Incare Home Care, LLC CurrentSince Nov 1, 2016 Accepting new patients
By the Bay Health CurrentSince Nov 1, 2016 Accepting new patients
Felton Institute CurrentSince Aug 4, 2023 Accepting new patients
Felton Institute CurrentSince Aug 4, 2023 Accepting new patients
Felton Institute Current Accepting new patients
Felton Institute Past Accepting new patients

Locations

1005 Atlantic Ave
Alameda, CA 94501
Phone (510) 318-6100

17 E Sir Francis Drake Blvd
Larkspur, CA 94939
Phone (415) 526-5643

1814 Franklin St
Oakland, CA 94612
Phone (510) 318-6100

30 E San Joaquin St
Ste 102
Salinas, CA 93901
Phone (831) 393-5994

1500 Franklin St
San Francisco, CA 94109

6221 Geary Blvd
San Francisco, CA 94121
Phone (415) 251-5770

1108 S El Camino Real
San Mateo, CA 94402
Phone (650) 458-0026

361 3rd St
Ste B
San Rafael, CA 94901
Phone (415) 747-8178

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1471564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747872000000",
    "number": "1083169064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2640 MARTIN LUTHER KING JR WAY",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947043238",
            "telephone_number": "510-981-5290",
            "fax_number": "510-981-5265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2640 MARTIN LUTHER KING JR WAY",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947043238",
            "telephone_number": "510-981-5290",
            "fax_number": "510-981-5265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALMER",
        "first_name": "ANNIE",
        "middle_name": "ROSE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-19",
        "last_updated": "2025-05-22",
        "certification_date": "2025-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "21227",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "21227",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

Verify at the official NPI Registry.