Individual provider Active NPI

Elizabeth Haupert, RN

  • Psychiatric/Mental Health Nurse Practitioner
  • Oakland, CA
National Provider Identifier
1114680824
Registry record updated Oct 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95023290 Issued in CA
Practice address
1605 Jefferson St
Oakland, CA 94612-1215
Phone
(510) 923-1099
Fax
(510) 923-0894
NPI assigned
Oct 19, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X 533963 CA
Registered Nurse 163W00000X 533963 CA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95023290 CA Primary

Addresses

Primary practice location

1605 Jefferson St
Oakland, CA 94612-1215

Mailing address

1605 Jefferson St
Oakland, CA 94612-1215
Phone (510) 923-1099

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
I20250327003674 CA Practitioner - Nurse Practitioner 7911420187 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1080 Marina Village Pkwy
Suite 100
Alameda, CA 94501-1011

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
533963CAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Telecare Corporation CurrentSince Jan 4, 2025 Accepting new patients
Telecare Corporation Current Accepting new patients
Telecare Corporation CurrentSince Jan 4, 2025 Accepting new patients

Locations

1080 Marina Village Pkwy
Ste 100
Alameda, CA 94501
Phone (510) 306-5660

280 17th St
Oakland, CA 94612
Phone (510) 238-5020

Organizations & group practices 3

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": "1634601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728950400000",
    "number": "1114680824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1605 JEFFERSON ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946121215",
            "telephone_number": "510-923-1099",
            "fax_number": "510-923-0894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1605 JEFFERSON ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946121215",
            "telephone_number": "510-923-1099",
            "fax_number": "510-923-0894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAUPERT",
        "first_name": "ELIZABETH",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-19",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "CA",
            "license": "533963",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "533963",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95023290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.