Individual provider Active NPI

Galadriel Ann Bonnel, RN, MSN, FNP

  • Family Nurse Practitioner
  • Vallejo, CA
National Provider Identifier
1912030453
Registry record updated Feb 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
14498 Issued in CA
Practice address
243 Georgia St
Suite B
Vallejo, CA 94590-5905
Phone
(707) 556-8100
NPI assigned
Mar 13, 2007
Last updated
Feb 27, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2024

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 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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

LicenseStateTypeSpecialty
598883CAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
La Clinica de la Raza Inc Past Accepting new patients
La Clinica de la Raza Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.