Individual provider Active NPI

Hannah Obanni

  • Pediatric Nurse Practitioner
  • Richmond, CA
National Provider Identifier
1982373643
Registry record updated Sep 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
95018316 Issued in CA
Practice address
2970 Hilltop Mall Rd Ste 305
Richmond, CA 94806-5274
Phone
(510) 222-5437
NPI assigned
Sep 7, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 95018316 CA Primary

Addresses

Primary practice location

2970 Hilltop Mall Rd Ste 305
Richmond, CA 94806-5274

Mailing address

6475 Christie Ave Ste 300
Emeryville, CA 94608-2263

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
I20211203000707 CA Practitioner - Nurse Practitioner 3577953645 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95018316CAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
UCSF Health Medical Foundation CurrentSince Oct 15, 2021 Accepting new patients

Locations

6475 Christie Ave
Ste 300
Emeryville, CA 94608
Phone (415) 476-7220

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

2970 Hilltop Mall Rd
Ste 305
San Pablo, CA 94806
Phone (510) 222-5437

Organizations & group practices 1

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": "1630972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630972800000",
    "number": "1982373643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6475 CHRISTIE AVE STE 300",
            "city": "EMERYVILLE",
            "state": "CA",
            "postal_code": "946082263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2970 HILLTOP MALL RD STE 305",
            "city": "RICHMOND",
            "state": "CA",
            "postal_code": "948065274",
            "telephone_number": "510-222-5437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBANNI",
        "first_name": "HANNAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-07",
        "last_updated": "2021-09-07",
        "certification_date": "2021-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CA",
            "license": "95018316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, CA

Sources for this page

Verify at the official NPI Registry.