Individual provider Active NPI

Laurel Ann Haeusslein, RN, NP

  • Nurse Practitioner
  • San Jose, CA
National Provider Identifier
1144745712
Registry record updated Apr 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95007240 Issued in CA
Practice address
2577 Samaritan Dr Ste 725
San Jose, CA 95124-4105
Phone
(408) 523-3960
NPI assigned
Aug 4, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95007240 CA Primary
Pediatric Registered Nurse 163WP0200X 95069832 CA
Registered Nurse 163W00000X 95069832 CA
Pediatric Nurse Practitioner 363LP0200X 95007240 CA

Addresses

Primary practice location

2577 Samaritan Dr Ste 725
San Jose, CA 95124-4105

Mailing address

PO Box 276950
Sacramento, CA 95827-6950

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
I20240711000990 CA Practitioner - Nurse Practitioner 0042755373 Reassigns benefits to 5 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95069832CAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
University of California San Francisco CurrentSince May 30, 2024 Accepting new patients
UCSF Medical Group Business Services Nurse Practitioner CurrentSince May 30, 2024 Accepting new patients
UCSF Medical Group Business Services CurrentSince May 30, 2024 Accepting new patients
University of California San Francisco CurrentSince May 30, 2024 Accepting new patients
UCSF Pediatrics Associates CurrentSince May 30, 2024 Accepting new patients
UCSF Dept of Surgery CurrentSince May 30, 2024 Accepting new patients
University of California San Francisco Current Accepting new patients

Locations

747 52nd St
Oakland, CA 94609
Phone (510) 428-3070

2330 Post St
San Francisco, CA 94115
Phone (415) 502-4444

505 Parnassus Ave
San Francisco, CA 94143
Phone (415) 476-9058

400 Parnassus Ave
#A632
San Francisco, CA 94143
Phone (415) 473-1000

Organizations & group practices 8

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": "1501804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777248000000",
    "number": "1144745712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 276950",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958276950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2577 SAMARITAN DR STE 725",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951244105",
            "telephone_number": "408-523-3960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAEUSSLEIN",
        "first_name": "LAUREL",
        "middle_name": "ANN",
        "credential": "RN, NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-04",
        "last_updated": "2026-04-27",
        "certification_date": "2026-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95007240",
            "primary": true
        },
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "CA",
            "license": "95069832",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95069832",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CA",
            "license": "95007240",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.