Individual provider Active NPI

Henriette Kenfack

  • Family Nurse Practitioner
  • El Cerrito, CA
National Provider Identifier
1972477032
Registry record updated Oct 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95037301 Issued in CA
Practice address
11461 San Pablo Ave # 153
El Cerrito, CA 94530-1916
Phone
(425) 516-2657
NPI assigned
Oct 1, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95037301 CA Primary

Addresses

Primary practice location

11461 San Pablo Ave # 153
El Cerrito, CA 94530-1916

Mailing address

11461 San Pablo Ave # 153
El Cerrito, CA 94530-1916
Phone (425) 516-2657

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
95037301CAMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1759276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759276800000",
    "number": "1972477032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11461 SAN PABLO AVE # 153",
            "city": "EL CERRITO",
            "state": "CA",
            "postal_code": "945301916",
            "telephone_number": "425-516-2657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11461 SAN PABLO AVE # 153",
            "city": "EL CERRITO",
            "state": "CA",
            "postal_code": "945301916",
            "telephone_number": "425-516-2657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENFACK",
        "first_name": "HENRIETTE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-01",
        "last_updated": "2025-10-01",
        "certification_date": "2025-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95037301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Cerrito, CA

Sources for this page

Verify at the official NPI Registry.