Active NPI
Kristen Phillips
- Registered Nurse
- Berkeley, CA
National Provider Identifier
1326593534
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 754418
- Practice address
- 2222 Bancroft Way
Tang Center
Berkeley, CA 94720-4301 - Phone
- (510) 642-3318
- NPI assigned
- Aug 17, 2016
- Last updated
- Aug 17, 2016
- 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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 754418 | CA | Primary |
Addresses
Primary practice location
2222 Bancroft Way
Tang Center
Berkeley, CA 94720-4301
Mailing address
1601 Excelsior Ave
Oakland, CA 94602-1604
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 |
|---|---|---|---|
| 754418 | CA | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1471392000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1471392000000",
"number": "1326593534",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1601 EXCELSIOR AVE",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946021604"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2222 BANCROFT WAY",
"address_2": "TANG CENTER",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947204301",
"telephone_number": "510-642-3318"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHILLIPS",
"first_name": "KRISTEN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-08-17",
"last_updated": "2016-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "CA",
"license": "754418",
"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 Aug 17, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.