Active NPI
Corinne Bourdillon
- Certified Registered Nurse Anesthetist
- Castro Valley, CA
National Provider Identifier
1609435874
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 95002759
- Practice address
- 20998 Redwood Rd
Castro Valley, CA 94546-5918 - Phone
- (510) 576-8500
- NPI assigned
- Jun 11, 2019
- 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 |
|---|---|---|---|---|
| Critical Care Medicine Registered Nurse | 163WC0200X | 2014021583 | MO | |
| Certified Registered Nurse Anesthetist | 367500000X | 95002759 | CA | Primary |
| Certified Registered Nurse Anesthetist | 367500000X | 1048073 | TX | |
| Critical Care Medicine Registered Nurse | 163WC0200X | RN2323700 | MA |
Addresses
Primary practice location
20998 Redwood Rd
Castro Valley, CA 94546-5918
Mailing address
3622 Randolph Ave
Santa Clara, CA 95051-6326
Phone (636) 399-4255
Other practice location 1
20 E Springfield St Apt 4
Boston, MA 02118-3258
Phone (636) 399-4255
Other practice location 2
6606 Lbj Fwy Ste 200
Dallas, TX 75240-6524
Phone (972) 715-5000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2021
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
3622 Randolph Ave
Santa Clara, CA 95051-6326
PO Box
Suite 34120
Reno, NV 89533
Merit-based Incentive Payment System (MIPS)
- Final score
- 88.94 of 100
- Quality
- 91.31
- Improvement activities
- 40
- Cost
- 79.05
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN2323700 | MA | MD | Critical Care Medicine Registered Nurse |
| 2014021583 | MO | MD | Critical Care Medicine Registered Nurse |
Organizations & group practices 1
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.
-
- Certified Registered Nurse Anesthetist
- Castro Valley, CA
- NPI 1366209629
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1560211200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1775174400000",
"number": "1609435874",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3622 RANDOLPH AVE",
"city": "SANTA CLARA",
"state": "CA",
"postal_code": "950516326",
"telephone_number": "636-399-4255"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20998 REDWOOD RD",
"city": "CASTRO VALLEY",
"state": "CA",
"postal_code": "945465918",
"telephone_number": "510-576-8500"
}
],
"practiceLocations": [
{
"address_1": "20 E Springfield St Apt 4",
"address_purpose": "LOCATION",
"city": "Boston",
"state": "MA",
"postal_code": "021183258",
"country_code": "US",
"telephone_number": "636-399-4255",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "6606 Lbj Fwy Ste 200",
"address_purpose": "LOCATION",
"city": "Dallas",
"state": "TX",
"postal_code": "752406524",
"country_code": "US",
"telephone_number": "972-715-5000",
"fax_number": "972-715-9976",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BOURDILLON",
"first_name": "CORINNE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-06-11",
"last_updated": "2026-04-03",
"certification_date": "2026-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "163WC0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, Critical Care Medicine",
"state": "MO",
"license": "2014021583",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "CA",
"license": "95002759",
"primary": true
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "TX",
"license": "1048073",
"primary": false
},
{
"code": "163WC0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, Critical Care Medicine",
"state": "MA",
"license": "RN2323700",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Castro Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.