Active NPI
Jennie Bertone
- Student in an Organized Health Care Education/Training Program
- Oakland, CA
National Provider Identifier
1366997272
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 2501 Harrison St
Oakland, CA 94612-3811 - Phone
- (510) 444-3344
- NPI assigned
- Aug 20, 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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
2501 Harrison St
Oakland, CA 94612-3811
Mailing address
2903 Wheeler St
Berkeley, CA 94705-1810
Phone (510) 599-5112
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 2, 2024 through Jan 2, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 122930 | CA | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| John F. Kennedy University | Past | Accepting new patients | |
| Oakland Counseling Center | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Marriage & Family Therapist
- Oakland, CA
- NPI 1871954388
-
- Case Management Agency
- Oakland, CA
- NPI 1053956755
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1471651200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1471651200000",
"number": "1366997272",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2903 WHEELER ST",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947051810",
"telephone_number": "510-599-5112"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2501 HARRISON ST",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946123811",
"telephone_number": "510-444-3344"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERTONE",
"first_name": "JENNIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-08-20",
"last_updated": "2016-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"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 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.