Kieu Phuong Proud

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

RN603923 Issued in CA

Practice address

830 University Ave
Berkeley, CA 94710-2044

Phone

(510) 981-5333

Fax

(510) 981-5345

NPI assigned

Jan 3, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• City of Berkeley Targeted Case Management

  • Case Management Agency
  • Berkeley, CA
  • NPI 1265612691
  NPD (past)

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

{
    "created_epoch": "1199318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383523200000",
    "number": "1154506590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1947 CENTER ST",
            "address_2": "2ND FLOOR",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947041169",
            "telephone_number": "510-981-5137",
            "fax_number": "510-981-5345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 UNIVERSITY AVE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947102044",
            "telephone_number": "510-981-5333",
            "fax_number": "510-981-5345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROUD",
        "first_name": "KIEU",
        "middle_name": "PHUONG",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-03",
        "last_updated": "2013-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "RN603923",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CA",
            "license": "16403",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Powers Prince, PH.D.
• Lonnie Prince, L.C.S.W.
• Hannah Prior
• Private Healthcare Facilities
• Private Pediatrics Incorporated
• Ariel F Provasoli, DC
• Ben C Pryor, CADCA
• Alison Psiuk, MA
• Psychosocial Therapy Licensed Marriage and Family Therapists Inc. (PsychoSocial Therapy)
• Psychplus Associates of California PC

• Registered Nurse in Berkeley, CA
• Providers in Berkeley, CA by specialty
• Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.