Kelli A Backlund, NP

Primary specialty

Women's Health Nurse PractitionerTaxonomy code 363LW0102X

License

95034378 Issued in CA

Practice address

3030 Alum Rock Ave
San Jose, CA 95127-2807

Phone

(408) 457-7100

NPI assigned

Mar 14, 2025

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kelli Carlson Former name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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

{
    "created_epoch": "1741910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741910400000",
    "number": "1619777166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3315 MONTGOMERY DR APT 167",
            "city": "SANTA CLARA",
            "state": "CA",
            "postal_code": "950543039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3030 ALUM ROCK AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951272807",
            "telephone_number": "408-457-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACKLUND",
        "first_name": "KELLI",
        "middle_name": "A",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-14",
        "last_updated": "2025-03-14",
        "certification_date": "2025-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "CA",
            "license": "95034378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLI",
            "last_name": "CARLSON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Faith Bacani
• Hien Thu Bach, LVN
• Amanda Bachuss, MD
• Back to Back Chiropractic
• Back to Back Chiropractic
• Justin Patrick Bacolor
• Chloe Bacon
• Christine Bacon, SLP
• Ryan Bacon
• Ayla Badal Abdishou, RBT- 18765886688

• Women's Health Nurse Practitioner in San Jose, CA
• Providers in San Jose, CA by specialty
• Women's Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.