Individual provider Active NPI

Kerrilynn Soldavini-Amayo, LVN

  • Licensed Practical Nurse
  • Oakland, CA
National Provider Identifier
1225220445
Registry record updated Aug 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
VN159261 Issued in CA
Practice address
1124 International Blvd
Oakland, CA 94606-4331
Phone
(510) 533-0800
NPI assigned
Aug 12, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X VN159261 CA Primary

Addresses

Primary practice location

1124 International Blvd
Oakland, CA 94606-4331

Mailing address

PO Box 720031
San Francisco, CA 94172-0031
Phone (510) 414-5511

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
VN159261CAMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1186876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186876800000",
    "number": "1225220445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 720031",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941720031",
            "telephone_number": "510-414-5511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1124 INTERNATIONAL BLVD",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946064331",
            "telephone_number": "510-533-0800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOLDAVINI-AMAYO",
        "first_name": "KERRILYNN",
        "credential": "LVN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-12",
        "last_updated": "2007-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "CA",
            "license": "VN159261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2007; 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.