Active NPI
Galadriel Ann Bonnel, RN, MSN, FNP
- Family Nurse Practitioner
- Vallejo, CA
National Provider Identifier
1912030453
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 14498
- Practice address
- 243 Georgia St
Suite B
Vallejo, CA 94590-5905 - Phone
- (707) 556-8100
- NPI assigned
- Mar 13, 2007
- Last updated
- Feb 27, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 598883 | CA | |
| Family Nurse Practitioner | 363LF0000X | 14498 | CA | Primary |
Addresses
Primary practice location
243 Georgia St
Suite B
Vallejo, CA 94590-5905
Mailing address
2344 6TH St
Berkeley, CA 94710-2412
Phone (510) 981-4100
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150714003147 | CA | Order and Referring Only - Nurse Practitioner | 3274580691 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science - Nursing, Nurse Practitioner, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 598883 | CA | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| La Clinica de la Raza Inc | Past | Accepting new patients | |
| La Clinica de la Raza Inc | Past | Accepting new patients |
Interoperability endpoints
- gbonnel280449@direct.ochin.org
Organizations & group practices 2
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.
-
dba La Clinica Dental at Children's Hospital Oakland
- Federally Qualified Health Center (FQHC)
- Oakland, CA
- NPI 1346262292
-
dba La Clinica Vallejo
- Federally Qualified Health Center (FQHC)
- Vallejo, CA
- NPI 1992811392
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173744000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1708992000000",
"number": "1912030453",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2344 6TH ST",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947102412",
"telephone_number": "510-981-4100",
"fax_number": "510-981-3263"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "243 GEORGIA ST",
"address_2": "SUITE B",
"city": "VALLEJO",
"state": "CA",
"postal_code": "945905905",
"telephone_number": "707-556-8100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BONNEL",
"first_name": "GALADRIEL",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"credential": "RN, MSN, FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-13",
"last_updated": "2024-02-27",
"certification_date": "2024-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "CA",
"license": "598883",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CA",
"license": "14498",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Vallejo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.