Kenneth A Harris, RN, CCRN

Primary specialty

Critical Care Medicine Registered NurseTaxonomy code 163WC0200X

License

782137 Issued in CA

Practice address

20103 Lake Chabot Rd
Castro Valley, CA 94546-5305

Phone

(510) 537-1234

NPI assigned

Sep 21, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1600646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1902412430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 COOSADA LN",
            "city": "COOSADA",
            "state": "AL",
            "postal_code": "360202919",
            "telephone_number": "334-268-9220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20103 LAKE CHABOT RD",
            "city": "CASTRO VALLEY",
            "state": "CA",
            "postal_code": "945465305",
            "telephone_number": "510-537-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "KENNETH",
        "middle_name": "A",
        "credential": "RN, CCRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-09-21",
        "last_updated": "2023-11-27",
        "certification_date": "2020-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "AL",
            "license": "1-105100",
            "primary": false
        },
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "CA",
            "license": "782137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "harrika@sutterhealth.org",
            "affiliation": "Y",
            "endpointDescription": "Work email address",
            "affiliationName": "Eden Medical Center",
            "address_1": "20103 Lake Chabot Rd",
            "city": "Castro Valley",
            "state": "CA",
            "country_code": "US",
            "postal_code": "945465305",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Tracy Renee Harbin, REGISTERED NURSE
• Susana Ines Smith Harbutt, M.D.
• Stephanie Harn, DC
• Tony K Harper II
• Joanna Harris
• Japera Akilah Harrison
• Erin Hartmann
• Heidi Kathryn Hausauer, D.D.S.
• Cynthia He
• Healing Lotus Wellness Companions LLC

• Critical Care Medicine Registered Nurse in Castro Valley, CA
• Providers in Castro Valley, CA by specialty
• Critical Care Medicine Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.