Individual provider Active NPI

Jacqueline Frank, CRNA

  • Certified Registered Nurse Anesthetist
  • Santa Clara, CA
National Provider Identifier
1649356296
Registry record updated Jan 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
NA2942 Issued in CA
Practice address
700 Lawrence Expressway
Santa Clara, CA 95051
Phone
(559) 459-6000
NPI assigned
Oct 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN611132 CA
Certified Registered Nurse Anesthetist 367500000X NA2942 CA Primary

Addresses

Primary practice location

700 Lawrence Expressway
Santa Clara, CA 95051

Mailing address

PO Box 7096
Stockton, CA 95267-0096
Phone (209) 956-7725

Other identifiers 3

IdentifierTypeStateIssuer
P00412646OtherCARAILROAD MEDICARE
NA0029420OtherCABLUE SHIELD OF CA
RN0029420MedicaidCA

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq Health Information Exchange (HIE) The Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041116001274 CA Practitioner - Certified Registered Nurse Anesthetist (Crna) 4385608603 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mai Nursing Anesthesia PCGroup PAC ID 2567858764, 35 clinicians
Permanente Medical Group IncGroup PAC ID 8921910225, 10,928 clinicians

Practice addresses (Care Compare)

1720 4TH St
Santa Rosa, CA 95404-3602
Phone (707) 546-8100

3600 Broadway
Oakland, CA 94611-5730
Phone (510) 752-1000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN611132CAMDRegistered Nurse
NA2942CAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Omni Anesthesia Associates, Inc. Nurse Anesthetist, Certified Registered CurrentSince Sep 1, 2004 Accepting new patients
Vallarine Dental, LLC CurrentSince Mar 1, 2013 Accepting new patients
Permanente Medical Group Inc Current Accepting new patients
Permanente Medical Group, Inc CurrentSince Sep 26, 2016 Accepting new patients
Mai Nursing Anesthesia PC CurrentSince Apr 28, 2024 Accepting new patients
Monterey Anesthesia Professionals Nurse Anesthetist, Certified Registered CurrentSince Jan 28, 2018 Accepting new patients
Permanente Medical Group Inc CurrentSince Sep 26, 2016 Accepting new patients
Anesthesiology Consultants of Toledo, Inc Past Accepting new patients

Locations

750 Auburn Ravine Rd
Auburn, CA 95603
Phone (530) 823-6131

4500 Morning Dr
Ste 102
Bakersfield, CA 93306
Phone (661) 437-4140

429 Llewellyn Ave
Campbell, CA 95008
Phone (408) 358-5000

445 S Cedar Ave
Fresno, CA 93702
Phone (559) 459-4000

2828 Fresno St
Ste 100
Fresno, CA 93721
Phone (559) 263-9648

4753 W Shaw Ave
Ste 101
Fresno, CA 93722
Phone (559) 277-8738

900 N Douty St
Hanford, CA 93230
Phone (559) 587-9014

3600 Broadway
Oakland, CA 94611
Phone (510) 752-6238

101 Monroe St
Petaluma, CA 94954
Phone (707) 763-4109

1700 San Pablo Ave
Ste D
Pinole, CA 94564
Phone (510) 724-9500

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

930 W Main St
Ripon, CA 95366
Phone (209) 599-4221

1441 Constitution Blvd
Salinas, CA 93906
Phone (831) 261-8090

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

700 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 851-5300

3003 Paul Sweet Rd
Santa Cruz, CA 95065
Phone (831) 462-1607

1720 4th St
Santa Rosa, CA 95404
Phone (707) 546-8100

3540 Mendocino Ave
Ste 200
Santa Rosa, CA 95403
Phone (707) 522-6200

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

2160 W Grant Line Rd
Ste 120
Tracy, CA 95377
Phone (209) 832-2095

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

320 N Crawford St
Willows, CA 95988
Phone (530) 934-2834

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641427200000",
    "number": "1649356296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7096",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952670096",
            "telephone_number": "209-956-7725",
            "fax_number": "209-956-7733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 LAWRENCE EXPRESSWAY",
            "city": "SANTA CLARA",
            "state": "CA",
            "postal_code": "95051",
            "telephone_number": "559-459-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRANK",
        "first_name": "JACQUELINE",
        "name_prefix": "Ms.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-27",
        "last_updated": "2022-01-06",
        "certification_date": "2022-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "RN611132",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "NA2942",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00412646",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CA",
            "identifier": "NA0029420",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RN0029420",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "700 Lawrence Expy",
            "city": "Santa Clara",
            "state": "CA",
            "country_code": "US",
            "postal_code": "950515173",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Santa Clara, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2022; 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.

Verify at the official NPI Registry.