Individual provider Active NPI

Jennifer Minn, CPNP-PC

  • Pediatric Nurse Practitioner
  • Oakland, CA
National Provider Identifier
1508217092
Registry record updated Aug 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
NP95009113 Issued in CA
Practice address
3100 Summit St
Oakland, CA 94609-3412
Phone
(510) 655-4000
NPI assigned
Jun 26, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 778995 CA
Registered Nurse 163W00000X 693805 NY
Pediatric Nurse Practitioner 363LP0200X 382730 NY
Pediatric Nurse Practitioner 363LP0200X NP95009113 CA Primary

Addresses

Primary practice location

3100 Summit St
Oakland, CA 94609-3412

Mailing address

3100 Summit St
Oakland, CA 94609-3412
Phone (510) 655-4000

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
778995CAMDRegistered Nurse
693805NYMDRegistered Nurse
NP95009113CAMDPediatric Nurse Practitioner
382730NYMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of California San Francisco Past Accepting new patients
University of California San Francisco Medical Center Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jminn116738@direct-ucsfmedicalcenter.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1466899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690934400000",
    "number": "1508217092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 SUMMIT ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093412",
            "telephone_number": "510-655-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 SUMMIT ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093412",
            "telephone_number": "510-655-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINN",
        "first_name": "JENNIFER",
        "credential": "CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-26",
        "last_updated": "2023-08-02",
        "certification_date": "2023-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "778995",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "693805",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "382730",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CA",
            "license": "NP95009113",
            "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 2, 2023; 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.