Individual provider Active NPI

Kyle Walsh

  • Family Nurse Practitioner
  • Oakland, CA
National Provider Identifier
1720400096
Registry record updated Jan 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
23303 Issued in CA
Practice address
2950 International Blvd
Oakland, CA 94601-2228
Phone
(510) 535-4400
NPI assigned
Jan 6, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2014

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 790183 CA
Family Nurse Practitioner 363LF0000X 23303 CA Primary

Addresses

Primary practice location

2950 International Blvd
Oakland, CA 94601-2228

Mailing address

2370 Market St # 406
San Francisco, CA 94114-1521
Phone (415) 652-4736

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
790183CAMDRegistered Nurse
23303CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Native American Health Center, Inc Current Accepting new patients
Native American Health Center, Inc CurrentSince May 25, 2016 Accepting new patients
Native American Health Center, Inc CurrentSince May 25, 2016 Accepting new patients

Locations

3124 International Blvd
#2D
Oakland, CA 94601

2950 International Blvd
Oakland, CA 94601
Phone (510) 485-5948

160 Capp St
San Francisco, CA 94110
Phone (415) 417-3500

Organizations & group practices 3

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": "1388966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388966400000",
    "number": "1720400096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2370 MARKET ST # 406",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941141521",
            "telephone_number": "415-652-4736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2950 INTERNATIONAL BLVD",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946012228",
            "telephone_number": "510-535-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALSH",
        "first_name": "KYLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-06",
        "last_updated": "2014-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "790183",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "23303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.