Active NPI
Kellie M. O. Takashima, NP
- Nurse Practitioner
- San Francisco, CA
National Provider Identifier
1568544401
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 95002446
- Practice address
- 2 Embarcadero Ctr Lbby Level
San Francisco, CA 94111-3823 - Phone
- (888) 663-6331
- Fax
- (415) 252-7176
- NPI assigned
- Oct 19, 2006
- 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 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | AP60755079 | WA | |
| Family Nurse Practitioner | 363LF0000X | RN2300400 | MA | |
| Family Nurse Practitioner | 363LF0000X | AP7772 | AZ | |
| Nurse Practitioner | 363L00000X | 95002446 | CA | Primary |
| Nurse Practitioner | 363L00000X | 339604 | NY |
Addresses
Primary practice location
2 Embarcadero Ctr Lbby Level
San Francisco, CA 94111-3823
Mailing address
1 Embarcadero Ctr Ste 1900
San Francisco, CA 94111-3723
Phone (415) 658-6791
Other practice location 1
30 Broad St Fl 45
New York, NY 10004-2942
Phone (212) 530-0630
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0000220004 | Other | HI | HMSA BILLING NUMBER |
| 55037802 | Medicaid | HI |
Other names 1
- Kellie M. O'Hara
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 |
|---|---|---|---|
| 225 | HI | MD | Mental Health Counselor |
| 339604 | NY | MD | Nurse Practitioner |
| AP7772 | AZ | MD | Family Nurse Practitioner |
| RN2300400 | MA | MD | Family Nurse Practitioner |
| AP60755079 | WA | MD | Family Nurse Practitioner |
| 95002446 | CA | MD | Certified Registered Nurse Anesthetist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161216000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1759363200000",
"number": "1568544401",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 EMBARCADERO CTR STE 1900",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941113723",
"telephone_number": "415-658-6791"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2 EMBARCADERO CTR LBBY LEVEL",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941113823",
"telephone_number": "888-663-6331",
"fax_number": "415-252-7176"
}
],
"practiceLocations": [
{
"address_1": "30 Broad St Fl 45",
"address_purpose": "LOCATION",
"city": "New York",
"state": "NY",
"postal_code": "100042942",
"country_code": "US",
"telephone_number": "212-530-0630",
"fax_number": "415-252-7176",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TAKASHIMA",
"first_name": "KELLIE",
"middle_name": "M. O.",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-19",
"last_updated": "2025-10-02",
"certification_date": "2025-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "WA",
"license": "AP60755079",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MA",
"license": "RN2300400",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "AZ",
"license": "AP7772",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "CA",
"license": "95002446",
"primary": true
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "NY",
"license": "339604",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HMSA BILLING NUMBER",
"identifier": "0000220004",
"state": "HI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "55037802",
"state": "HI"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "KELLIE",
"last_name": "O'HARA",
"middle_name": "M.",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in San Francisco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.