Ava Sara Hosseini, RN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

202101558NP Issued in OR

Practice address

1100 San Leandro Blvd
San Leandro, CA 94577-1595

Phone

(510) 267-8000

NPI assigned

Mar 5, 2022

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

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective May 2, 2023 through May 2, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

State licenses

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

{
    "created_epoch": "1646438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649980800000",
    "number": "1194472514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 E 9TH ST",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917865340",
            "telephone_number": "909-297-6366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 SAN LEANDRO BLVD",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945771595",
            "telephone_number": "510-267-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOSSEINI",
        "first_name": "AVA",
        "middle_name": "SARA",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-05",
        "last_updated": "2022-04-15",
        "certification_date": "2022-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95174923",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "202101558NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bridget Horgan
• Horizon Services, Inc
• Lucy Hormberg, MD
• Karen Yurch Horn, NP
• Juliana Marie Horna-Rojas
• Zahra Hosseini, DDS
• William D Hough
• Austin Houlgate
• Chawnte Howard
• Michael Howard, B.A.

• Psychiatric/Mental Health Nurse Practitioner in San Leandro, CA
• Providers in San Leandro, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.