Individual provider Active NPI

Kellie M. O. Takashima, NP

  • Nurse Practitioner
  • San Francisco, CA
National Provider Identifier
1568544401
Registry record updated Oct 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95002446 Issued in CA
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

Updated by the provider on Oct 2, 2025

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
0000220004OtherHIHMSA BILLING NUMBER
55037802MedicaidHI

Other names 1

  • Kellie M. O'Hara Former name

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
225HIMDMental Health Counselor
339604NYMDNurse Practitioner
AP7772AZMDFamily Nurse Practitioner
RN2300400MAMDFamily Nurse Practitioner
AP60755079WAMDFamily Nurse Practitioner
95002446CAMDCertified 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.

Verify at the official NPI Registry.