Individual provider Active NPI

Joana Ruby Callanta Bueno, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Oakland, CA
National Provider Identifier
1578057576
Registry record updated Mar 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95010538 Issued in CA
Practice address
3300 Webster St Ste 612
Oakland, CA 94609-3101
Phone
(855) 501-1004
NPI assigned
Jun 22, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 61653032 WA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X SP019733 PA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95010538 CA Primary

Addresses

Primary practice location

3300 Webster St Ste 612
Oakland, CA 94609-3101

Mailing address

3835 N Freeway Blvd Ste 100
Sacramento, CA 95834-1954
Phone (916) 576-7900

Other identifiers 4

IdentifierTypeStateIssuer
1036687680002MedicaidPA
61653032OtherWAWA STATE BOARD OF NURSING
SP019733OtherPAPA STATE BOARD OF NURSING
95010538OtherCACA STATE BOARD OF NURSING

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210816003540 PA Practitioner - Nurse Practitioner 0446655393 Reassigns benefits to 1 organization
I20220325000871 CA Practitioner - Nurse Practitioner 0446655393 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
61653032WAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Resources for Human Development, Inc. CurrentSince May 11, 2021 Accepting new patients
Family Practice & Counseling Services Network, Inc. CurrentSince May 11, 2021 Accepting new patients
Regents of the University of California CurrentSince Sep 1, 2022 Accepting new patients
Regents of the University of California CurrentSince Sep 1, 2022 Accepting new patients
Resources for Human Development, Inc. Current Accepting new patients
Community Research Foundation Inc CurrentSince Jan 17, 2022 Accepting new patients
Family Practice & Counseling Services Network, Inc. Past Accepting new patients
Community Research Foundation Inc PastSince Feb 1, 2022 Accepting new patients

Locations

File 57326
Los Angeles, CA 90074

200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5754

995 Gateway Center Way
Ste 300
San Diego, CA 92102
Phone (619) 398-2168

1045 9th Ave
San Diego, CA 92101
Phone (619) 235-2600

1202 Morena Blvd
Ste 300
San Diego, CA 92110
Phone (619) 276-8112

4700 Wissahickon Ave
Ste 118
Philadelphia, PA 19144
Phone 26759736006771

6120 Woodland Ave
Fl The
Philadelphia, PA 19142
Phone (215) 727-4721

4700 Wissahickon Ave
Bldg D
Philadelphia, PA 19144
Phone (215) 843-9720

4700 Wissahickon Ave
Philadelphia, PA 19144
Phone (215) 843-9720

2300 W Master St
Philadelphia, PA 19121
Phone (267) 687-1172

Organizations & group practices 8

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": "1529625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742256000000",
    "number": "1578057576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3835 N FREEWAY BLVD STE 100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958341954",
            "telephone_number": "916-576-7900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 WEBSTER ST STE 612",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093101",
            "telephone_number": "855-501-1004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUENO",
        "first_name": "JOANA RUBY",
        "middle_name": "CALLANTA",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-22",
        "last_updated": "2025-03-18",
        "certification_date": "2025-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "61653032",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "PA",
            "license": "SP019733",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95010538",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1036687680002",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA STATE BOARD OF NURSING",
            "identifier": "61653032",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA STATE BOARD OF NURSING",
            "identifier": "SP019733",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA STATE BOARD OF NURSING",
            "identifier": "95010538",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.