Individual provider Active NPI

Brianna Weller, NP

  • Nurse Practitioner
  • Berkeley, CA
National Provider Identifier
1801542071
Registry record updated Aug 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
NP95019902 Issued in CA
Practice address
1901 4TH St
Berkeley, CA 94710-1985
Phone
(510) 929-1400
Fax
(510) 929-1414
NPI assigned
Feb 26, 2022
Last updated
Aug 1, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NP95019902 CA Primary

Addresses

Primary practice location

1901 4TH St
Berkeley, CA 94710-1985

Mailing address

PO Box 511250
Los Angeles, CA 90051-7805
Phone (510) 929-1400

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
I20220709000197 CA Practitioner - Nurse Practitioner 6204216195 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NP95019902CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
El-Bershawi Medical Corp CurrentSince Apr 1, 2025 Accepting new patients
Lightbridge Hospice, LLC PastSince Jun 20, 2022 Accepting new patients
Pacific Professional Surgical Group Inc Past Accepting new patients
Saurabh Jain MD Inc PastSince Mar 1, 2022 Accepting new patients

Locations

4234 Riverwalk Pkwy
Ste 230
Riverside, CA 92505
Phone (951) 373-5819

Interoperability endpoints

  • Direct secure messaging: brianna.weller@299395540647940.direct.elationemr.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1645833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722470400000",
    "number": "1801542071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 511250",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900517805",
            "telephone_number": "510-929-1400",
            "fax_number": "510-929-1414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 4TH ST",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947101985",
            "telephone_number": "510-929-1400",
            "fax_number": "510-929-1414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLER",
        "first_name": "BRIANNA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-26",
        "last_updated": "2024-08-01",
        "certification_date": "2024-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NP95019902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

Verify at the official NPI Registry.