Individual provider Active NPI

Jessica Ruano

  • Nurse Practitioner
  • Berkeley, CA
National Provider Identifier
1568106995
Registry record updated Feb 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95017725 Issued in CA
Practice address
2905 Telegraph Ave
Berkeley, CA 94705-2017
Phone
(510) 841-4525
NPI assigned
Apr 22, 2022
Last updated
Feb 13, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 13, 2025

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 95017725 CA Primary

Addresses

Primary practice location

2905 Telegraph Ave
Berkeley, CA 94705-2017

Mailing address

2905 Telegraph Ave
Berkeley, CA 94705-2017
Phone (510) 841-4525

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
I20230228000877 CA Practitioner - Nurse Practitioner 6901279694 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2905 Telegraph Ave
Berkeley, CA 94705-2017
Phone (510) 841-0411

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
J M Geiss DO Apc Single Specialty CurrentSince Feb 27, 2023 Accepting new patients
East Bay Nephrology Medical Group, Inc. Single Specialty Current Accepting new patients
California PHS PC Single Specialty CurrentSince Feb 22, 2023 Accepting new patients
East Bay Nephrology Medical Group, Inc. Single Specialty CurrentSince Feb 10, 2025 Accepting new patients
Marin Gastroenterology Single Specialty PastSince Apr 1, 2022 Accepting new patients

Locations

2905 Telegraph Ave
Berkeley, CA 94705
Phone (510) 841-0411

1420 E Palomar St
Chula Vista, CA 91913

7638 N Ingram Ave
#111A
Fresno, CA 93711

3415 S Sepulveda Blvd
Ste 1100
Los Angeles, CA 90034
Phone (424) 348-4558

1900 Coffee Rd
Modesto, CA 95355
Phone (209) 491-0904

520 Superior Ave
Ste 255
Newport Beach, CA 92663
Phone (949) 720-9266

2592 N Santiago Blvd
Orange, CA 92867
Phone (714) 577-2271

3550 Churn Creek Rd
Redding, CA 96002
Phone (530) 222-3630

5 Hutton Centre Dr
Ste 950
Santa Ana, CA 92707
Phone (855) 434-7663

28650 Newhall Ranch Rd
Santa Clarita, CA 91355
Phone (661) 347-0051

127 Hospital Dr
Ste 204
Vallejo, CA 94589
Phone (707) 642-7510

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/19831/brand/2/csg/1/fhir/r4
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: jessica.ruano.1@6134.direct.athenahealth.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1650585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739404800000",
    "number": "1568106995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2905 TELEGRAPH AVE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947052017",
            "telephone_number": "510-841-4525",
            "fax_number": "510-848-9970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2905 TELEGRAPH AVE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947052017",
            "telephone_number": "510-841-4525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUANO",
        "first_name": "JESSICA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-22",
        "last_updated": "2025-02-13",
        "certification_date": "2025-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95017725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

Verify at the official NPI Registry.