Individual provider Active NPI

Catherine Nguyen

  • Psychiatric/Mental Health Nurse Practitioner
  • San Francisco, CA
National Provider Identifier
1669142865
Registry record updated Jan 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
NP95018239 Issued in CA
Practice address
4150 Clement St
San Francisco, CA 94121-1563
Phone
(415) 221-4810
NPI assigned
Sep 18, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NP95018239 CA Primary

Addresses

Primary practice location

4150 Clement St
San Francisco, CA 94121-1563

Mailing address

4150 Clement St
San Francisco, CA 94121-1563
Phone (415) 221-4810

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20230201001724 CA Practitioner - Nurse Practitioner 4385015262 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NP95018239CAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lifelong Medical Care CurrentSince Nov 14, 2022 Accepting new patients
Lifelong Medical Care CurrentSince Nov 14, 2022 Accepting new patients

Locations

2344 6th St
Berkeley, CA 94710
Phone (510) 981-3203

10700 MacArthur Blvd
Ste 14B
Oakland, CA 94605
Phone (510) 563-4300

Organizations & group practices 2

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": "1631923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641945600000",
    "number": "1669142865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4150 CLEMENT ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941211563",
            "telephone_number": "415-221-4810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4150 CLEMENT ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941211563",
            "telephone_number": "415-221-4810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "CATHERINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-18",
        "last_updated": "2022-01-12",
        "certification_date": "2022-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "NP95018239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.