Individual provider Active NPI

Kathleen A Berra, N.P.

  • Nurse Practitioner
  • Redwood City, CA
National Provider Identifier
1386698520
Registry record updated Mar 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
190163/8364 Issued in CA
Practice address
2900 Whipple Ave
Ste 230
Redwood City, CA 94062
Phone
(650) 306-2300
Fax
(650) 306-2336
NPI assigned
May 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 190163/8364 CA Primary

Addresses

Primary practice location

2900 Whipple Ave
Ste 230
Redwood City, CA 94062

Mailing address

2900 Whipple Ave
Suite 230
Redwood City, CA 94062-2843
Phone (650) 306-2300

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
190163/8364CAMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457395200000",
    "number": "1386698520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 WHIPPLE AVE",
            "address_2": "SUITE 230",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940622843",
            "telephone_number": "650-306-2300",
            "fax_number": "650-306-2336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 WHIPPLE AVE",
            "address_2": "STE 230",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "94062",
            "telephone_number": "650-306-2300",
            "fax_number": "650-306-2336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRA",
        "first_name": "KATHLEEN",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-20",
        "last_updated": "2016-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "190163/8364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redwood City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 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.

Verify at the official NPI Registry.