Individual provider Active NPI

Kayla Vaughan, MSN, CPNP-AC, CCRN

  • Pediatric Nurse Practitioner
  • San Francisco, CA
National Provider Identifier
1407543267
Registry record updated Apr 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
NP95024187 Issued in CA
Practice address
1975 4TH St
San Francisco, CA 94143-2351
Phone
(415) 353-1955
NPI assigned
Apr 21, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X NP95024187 CA Primary

Addresses

Primary practice location

1975 4TH St
San Francisco, CA 94143-2351

Mailing address

6124 Ruthland Rd
Oakland, CA 94611-1860
Phone (510) 332-9078

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230518001931 CA Practitioner - Nurse Practitioner 6800252776 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
UCSF Pediatrics AssociatesGroup PAC ID 6204749112, 102 clinicians

Practice addresses (Care Compare)

1975 4TH St
San Francisco, CA 94143-2351
Phone (415) 476-1000

505 Parnassus Ave
San Francisco, CA 94143-2204
Phone (415) 476-1000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP95024187CAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
UCSF Medical Group Business Services CurrentSince May 11, 2023 Accepting new patients
University of California San Francisco CurrentSince May 11, 2023 Accepting new patients
UCSF Pediatrics Associates CurrentSince May 11, 2023 Accepting new patients
UCSF Medical Group Business Services CurrentSince May 11, 2023 Accepting new patients
University of California San Francisco CurrentSince May 11, 2023 Accepting new patients
UCSF Dept of Surgery CurrentSince May 11, 2023 Accepting new patients
University of California San Francisco Medical Center Past Accepting new patients
University of California San Francisco Past Accepting new patients

Locations

3100 San Pablo Ave
Berkeley, CA 94702
Phone (510) 985-5020

2330 Post St
San Francisco, CA 94115
Phone (415) 502-4444

400 Parnassus Ave
#A632
San Francisco, CA 94143
Phone (415) 473-1000

2001 The Embarcadero
Ste 1500
San Francisco, CA 94143
Phone (415) 353-1606

505 Parnassus Ave
San Francisco, CA 94143
Phone (415) 476-9058

550 16th St
Fl 5
San Francisco, CA 94158
Phone (415) 476-5153

1975 4th St
San Francisco, CA 94143
Phone (415) 353-3000

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1682035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682035200000",
    "number": "1407543267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6124 RUTHLAND RD",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946111860",
            "telephone_number": "510-332-9078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1975 4TH ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941432351",
            "telephone_number": "415-353-1955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAUGHAN",
        "first_name": "KAYLA",
        "credential": "MSN, CPNP-AC, CCRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-21",
        "last_updated": "2023-04-21",
        "certification_date": "2023-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CA",
            "license": "NP95024187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.