Jessica B Barra, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP11576 Issued in AZ

Practice address

951 Mariners Island Blvd Ste 300
San Mateo, CA 94404-1560

Phone

(772) 217-4557

Fax

(888) 352-7383

NPI assigned

Aug 7, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 8

Addresses

Other names 1

• Jessica B Crider Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• C.Funsho Fagbohun,MD,PHD PA

  • Obstetrics & Gynecology Physician
  • Richmond, TX
  • NPI 1932332426
  NPD (past)
• Providence General Medicine, PC

  • Internal Medicine Physician
  • Phoenix, AZ
  • NPI 1164693974
  NPD (past)

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

{
    "created_epoch": "1533600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614556800000",
    "number": "1114406519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8025 E TUCKEY LN",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852505651",
            "telephone_number": "480-254-1131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "951 MARINERS ISLAND BLVD STE 300",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944041560",
            "telephone_number": "772-217-4557",
            "fax_number": "888-352-7383"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1701 W Glendale Ave Ste 6",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850219701",
            "country_code": "US",
            "telephone_number": "602-246-9090",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8655 E Via De Ventura Ste F125",
            "address_purpose": "LOCATION",
            "city": "Scottsdale",
            "state": "AZ",
            "postal_code": "852583579",
            "country_code": "US",
            "telephone_number": "480-657-0304",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1003 Bishop St Ste 1600",
            "address_purpose": "LOCATION",
            "city": "Honolulu",
            "state": "HI",
            "postal_code": "968136452",
            "country_code": "US",
            "telephone_number": "772-217-4557",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "40 Technology Pkwy S Ste 300",
            "address_purpose": "LOCATION",
            "city": "Norcross",
            "state": "GA",
            "postal_code": "300922924",
            "country_code": "US",
            "telephone_number": "772-217-4557",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1821 Logan Ave",
            "address_purpose": "LOCATION",
            "city": "Cheyenne",
            "state": "WY",
            "postal_code": "820015007",
            "country_code": "US",
            "telephone_number": "772-217-4557",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 Deschutes Way SW Ste 208",
            "address_purpose": "LOCATION",
            "city": "Tumwater",
            "state": "WA",
            "postal_code": "985017719",
            "country_code": "US",
            "telephone_number": "772-217-4557",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "112 N Curry St",
            "address_purpose": "LOCATION",
            "city": "Carson City",
            "state": "NV",
            "postal_code": "897034934",
            "country_code": "US",
            "telephone_number": "772-217-4557",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "726 E Michigan Dr Ste 101",
            "address_purpose": "LOCATION",
            "city": "Hobbs",
            "state": "NM",
            "postal_code": "882403467",
            "country_code": "US",
            "telephone_number": "772-217-4557",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1201 Hays St",
            "address_purpose": "LOCATION",
            "city": "Tallahassee",
            "state": "FL",
            "postal_code": "323012699",
            "country_code": "US",
            "telephone_number": "772-217-4557",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "222 Jefferson Blvd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Warwick",
            "state": "RI",
            "postal_code": "028883855",
            "country_code": "US",
            "telephone_number": "772-217-4557",
            "fax_number": "888-352-7383",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BARRA",
        "first_name": "JESSICA",
        "middle_name": "B",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-07",
        "last_updated": "2021-03-01",
        "certification_date": "2021-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "70",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN285115",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP11576",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "54965",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "819746",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP60983710",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "HI",
            "license": "APRN-2727",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WY",
            "license": "44356",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "CRIDER",
            "middle_name": "B",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kaitlyn Rose Barnett
• Cherise Barney, BA
• Steven Bradford Barney, LMFT
• Anthony Michael Barone
• Ronald H Barr, DDS
• Elisabeth Barragan
• Francisco Javier Barragan Jr.
• Ivanna Aymmet Barragan
• Carolina Marisol Monica Barraza
• Alison Barrera

• Family Nurse Practitioner in San Mateo, CA
• Providers in San Mateo, 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 Mar 1, 2021; 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.