Active NPI
Jennifer Minn, CPNP-PC
- Pediatric Nurse Practitioner
- Oakland, CA
National Provider Identifier
1508217092
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- NP95009113
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 778995 | CA | MD | Registered Nurse |
| 693805 | NY | MD | Registered Nurse |
| NP95009113 | CA | MD | Pediatric Nurse Practitioner |
| 382730 | NY | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of California San Francisco | Past | Accepting new patients | |
| University of California San Francisco Medical Center | Past | Accepting new patients |
Interoperability endpoints
- 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.
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- NPI 1144325440
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.