Individual provider Active NPI

Aimee Erin Paulson, FNP-C

  • Family Nurse Practitioner
  • Oakland, CA
National Provider Identifier
1740463611
Registry record updated Nov 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
17897 Issued in CA
Practice address
4333 Piedmont Ave
Oakland, CA 94611-4715
Phone
(510) 594-7400
NPI assigned
Dec 13, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2012

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 715799 CA
Family Nurse Practitioner 363LF0000X 17897 CA Primary

Addresses

Primary practice location

4333 Piedmont Ave
Oakland, CA 94611-4715

Mailing address

4333 Piedmont Ave
Oakland, CA 94611-4715
Phone (510) 594-7400

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
I20090112000739 CA Practitioner - Nurse Practitioner 4486717816 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Laksmi Ananta IncGroup PAC ID 7113257585, 2 clinicians

Practice addresses (Care Compare)

704 Saddle Ridge Way
Fairfield, CA 94534-6793
Phone (707) 301-1657

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
715799CAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Laksmi Ananta Inc CurrentSince Nov 19, 2019 Accepting new patients

Locations

525 Oregon St
Vallejo, CA 94590
Phone (707) 301-1657

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.

Hospital & facility affiliations 2

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": "1197504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352160000000",
    "number": "1740463611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4333 PIEDMONT AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946114715",
            "telephone_number": "510-594-7400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4333 PIEDMONT AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946114715",
            "telephone_number": "510-594-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAULSON",
        "first_name": "AIMEE",
        "middle_name": "ERIN",
        "name_prefix": "Ms.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-13",
        "last_updated": "2012-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "715799",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "17897",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.