Active NPI
Dana Lynne Kelly, PA
- Emergency Clinical Nurse Specialist
- Oakland, CA
National Provider Identifier
1326020397
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Clinical Nurse Specialist
- License
- PA13877
- Practice address
- 1411 East 31St St
Oakland, CA 94602-1018 - Phone
- (209) 342-2300
- Fax
- (209) 524-4240
- NPI assigned
- Nov 16, 2005
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Emergency Clinical Nurse Specialist | 364SE0003X | PA13877 | CA | Primary |
Addresses
Primary practice location
1411 East 31St St
Oakland, CA 94602-1018
Mailing address
4301 North Star Way
Modesto, CA 95356
Phone (209) 342-2300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0PA138770 | Medicaid | CA |
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)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13877 | CA | MD | Speech-Language Pathologist |
| PA13877 | CA | MD | Emergency Clinical Nurse Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132099200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1326020397",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4301 NORTH STAR WAY",
"city": "MODESTO",
"state": "CA",
"postal_code": "95356",
"telephone_number": "209-342-2300",
"fax_number": "209-524-4240"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1411 EAST 31ST ST",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946021018",
"telephone_number": "209-342-2300",
"fax_number": "209-524-4240"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLY",
"first_name": "DANA",
"middle_name": "LYNNE",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-11-16",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "364SE0003X",
"taxonomy_group": "",
"desc": "Clinical Nurse Specialist, Emergency",
"state": "CA",
"license": "PA13877",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0PA138770",
"state": "CA"
}
],
"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 Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.