Jenna Lynn Belobraidic Kuru, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

95011989 Issued in CA

Practice address

1460 Maria LN Ste 300
Walnut Creek, CA 94596-5314

Phone

(510) 859-8082

Fax

(510) 275-1162

NPI assigned

Jun 14, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Oct 28, 2024 through Oct 28, 2026

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lifestancehealth.jennakuru@148377.advancedmd-direct.com

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.

• Concordis Behavioral Health, a Professional Nursing Organization

  • Psychiatric/Mental Health Nurse Practitioner
  • San Jose, CA
  • NPI 1588411888
  NPD Authorized official

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

{
    "created_epoch": "1560470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725408000000",
    "number": "1235799032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 S BASCOM AVE STE 2005",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951283538",
            "telephone_number": "510-859-8082",
            "fax_number": "510-275-1162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1460 MARIA LN STE 300",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945965314",
            "telephone_number": "510-859-8082",
            "fax_number": "510-275-1162"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "950 S Bascom Ave Ste 2005",
            "address_purpose": "LOCATION",
            "city": "San Jose",
            "state": "CA",
            "postal_code": "951283538",
            "country_code": "US",
            "telephone_number": "510-859-8082",
            "fax_number": "510-275-1162",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KURU",
        "first_name": "JENNA",
        "middle_name": "LYNN BELOBRAIDIC",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-14",
        "last_updated": "2024-09-04",
        "certification_date": "2024-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95011989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jenna.kuru@concordisbh.com",
            "affiliation": "Y",
            "endpointDescription": "email address",
            "affiliationName": "Concordis Behavioral Health, A Professional Nursing Organization",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "950 S Bascom Ave Ste 2005",
            "city": "San Jose",
            "state": "CA",
            "country_code": "US",
            "postal_code": "951283538",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• David Chien-Yuan Kung, O.D.
• Henry I-Tsai Kung, M.D.
• Jason Kung, MD
• Gretchen Kunitz, MD
• Stewart Z. Kupetz, MD
• Pavani Kuruma, MD
• Nadine Kurzke
• Matthias David Kurzrock, DDS
• Lauren Kussler, ASW
• Jessica Michelle Kutsoginis

• Psychiatric/Mental Health Nurse Practitioner in Walnut Creek, CA
• Providers in Walnut Creek, 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 Sep 4, 2024; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.