Individual provider Active NPI

Kathleen Jan Gillis, RN MSN FNP

  • Family Nurse Practitioner
  • Oakland, CA
National Provider Identifier
1750354882
Registry record updated Jun 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
7266 Issued in CA
Practice address
2950 International Blvd
Oakland, CA 94601-2228
Phone
(510) 535-4400
NPI assigned
Feb 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2025

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 RN289570 CA
Family Nurse Practitioner 363LF0000X 7266 CA Primary

Addresses

Primary practice location

2950 International Blvd
Oakland, CA 94601-2228

Mailing address

3100 Telegraph Ave
Suite 2102
Oakland, CA 94609-3210
Phone (510) 286-8160

Other practice location 1

3100 Telegraph Ave
Suite 2102
Oakland, CA 94609-3210
Phone (510) 286-8160

Other identifiers 1

IdentifierTypeStateIssuer
GR0028630MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN289570CAMDRegistered Nurse
7266CAMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1139443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750118400000",
    "number": "1750354882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 TELEGRAPH AVE",
            "address_2": "SUITE 2102",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093210",
            "telephone_number": "510-286-8160",
            "fax_number": "510-286-8158"
        },
        {
            "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": [
        {
            "address_1": "3100 Telegraph Ave",
            "address_2": "Suite 2102",
            "address_purpose": "LOCATION",
            "city": "Oakland",
            "state": "CA",
            "postal_code": "946093210",
            "country_code": "US",
            "telephone_number": "510-286-8160",
            "fax_number": "510-286-8158",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GILLIS",
        "first_name": "KATHLEEN",
        "middle_name": "JAN",
        "name_prefix": "Ms.",
        "credential": "RN MSN FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-09",
        "last_updated": "2025-06-17",
        "certification_date": "2025-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "RN289570",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "7266",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0028630",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.