Individual provider Active NPI

Yulia A Pavlenko, RN, CCRN

  • Certified Registered Nurse Anesthetist
  • Oakland, CA
National Provider Identifier
1922625284
Registry record updated Dec 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
NA95002521 Issued in CA
Practice address
747 52ND St
Oakland, CA 94609-1809
Phone
(510) 428-3000
NPI assigned
Jul 1, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X NA95002521 CA Primary

Addresses

Primary practice location

747 52ND St
Oakland, CA 94609-1809

Mailing address

747 52ND St
Oakland, CA 94609-1809
Phone (510) 428-3000

Other names 1

  • Julia Pavlenko Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241126003786 CA Practitioner - Certified Registered Nurse Anesthetist (Crna) 1456886555 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NA95002521CAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Sedaze Anesthesia Consultants a Professional Nursing Corporation Nurse Anesthetist, Certified Registered CurrentSince Dec 20, 2024 Accepting new patients
University of California San Francisco CurrentSince Nov 21, 2024 Accepting new patients
University of California San Francisco CurrentSince Nov 21, 2024 Accepting new patients
UCSF Medical Group Business Services CurrentSince Nov 21, 2024 Accepting new patients
University Anesthesia Medical Group CurrentSince Nov 21, 2024 Accepting new patients
University of California San Francisco Current Accepting new patients
UCSF Medical Group Business Services CurrentSince Nov 21, 2024 Accepting new patients
UCSF Medical Center Past Accepting new patients
University of California San Francisco Medical Center Past Accepting new patients

Locations

20998 Redwood Rd
Castro Valley, CA 94546
Phone (510) 538-2828

747 52nd St
Oakland, CA 94609
Phone (510) 428-3070

2288 Auburn Blvd
Ste 201
Sacramento, CA 95821
Phone (916) 646-8300

2330 Post St
San Francisco, CA 94115
Phone (415) 502-4444

505 Parnassus Ave
San Francisco, CA 94143
Phone (415) 476-9058

400 Parnassus Ave
#A632
San Francisco, CA 94143
Phone (415) 473-1000

1739 4th St
Santa Rosa, CA 95404
Phone (707) 528-6331

Organizations & group practices 9

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

NPI Registry JSON

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

{
    "created_epoch": "1593561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733443200000",
    "number": "1922625284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "747 52ND ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946091809",
            "telephone_number": "510-428-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "747 52ND ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946091809",
            "telephone_number": "510-428-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAVLENKO",
        "first_name": "YULIA",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "RN, CCRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-01",
        "last_updated": "2024-12-06",
        "certification_date": "2024-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "NA95002521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JULIA",
            "last_name": "PAVLENKO",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Dec 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.