Active NPI
Brian Christopher Vassalo
- Family Nurse Practitioner
- Berkeley, CA
National Provider Identifier
1295210995
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 95010119
- Practice address
- 1528 Woolsey St Apt D
Berkeley, CA 94703-2353 - Phone
- (510) 999-2728
- NPI assigned
- Sep 27, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 95010119 | CA | Primary |
Addresses
Primary practice location
1528 Woolsey St Apt D
Berkeley, CA 94703-2353
Mailing address
1528 Woolsey St Apt D
Berkeley, CA 94703-2353
Phone (510) 999-2728
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
| License | State | Type | Specialty |
|---|---|---|---|
| 95010119 | CA | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1538006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1538006400000",
"number": "1295210995",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1528 WOOLSEY ST APT D",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947032353",
"telephone_number": "510-999-2728"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1528 WOOLSEY ST APT D",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947032353",
"telephone_number": "510-999-2728"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VASSALO",
"first_name": "BRIAN",
"middle_name": "CHRISTOPHER",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-09-27",
"last_updated": "2018-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CA",
"license": "95010119",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Berkeley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.