ELSA PETRONELLA VAN BERRY (NPI# 1083042162) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083042162 |
| Entity Type | Individual |
| Full Name | ELSA PETRONELLA VAN BERRY |
| Credential | CRYT, RN, MSN,FNP-BC |
| Practice Address |
3100 Summit St Fl 2 Oakland CA 94609-3412 |
| Mailing Address |
3687 Mt Diablo Blvd Ste 200 Lafayette CA 94549-3746 |
| Practice Telephone | 5108698865 |
| Practice Fax Number | 5108696271 |
| Mailing Telephone | 5102046660 |
| Enumeration Date | 2013-10-28 |
| Last Update Date | 2017-12-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
2011003399 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | MEDICARE PROVIDER # | 55-1876 | 01 |
| Street Address |
3100 SUMMIT ST FL 2 |
| City | OAKLAND |
| State | CA |
| Zip Code | 94609-3412 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265484240 | Andrea Minor Thach | Internal Medicine | 3100 Summit St Fl 2, Oakland, CA 94609-3412 | 2006-05-17 |
| 1811543457 | Bharavi Brahmbhatt | Nurse Practitioner | 3100 Summit St Fl 2, Suite 2549, Oakland, CA 94609-3412 | 2019-08-09 |
| 1639698947 | Matthew David Reynolds | Registered Nurse | 3100 Summit St Fl 2, Oakland, CA 94609 | 2017-09-18 |
| 1649604497 | Diana Ung | Pharmacist | 3100 Summit St Fl 2, Oakland, CA 94609 | 2013-08-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104457159 | Gerard John-charles Coughlin | Student in an Organized Health Care Education/Training Program | Samuel Merritt University, 3100 Telegraph Avenue, Oakland, CA 94609 | 2020-01-29 |
| 1417502022 | Michael Knittel | Registered Nurse | 370 Hawthorne Ave, Oakland, CA 94609 | 2019-08-09 |
| 1962057562 | Nicole Kjolby | Registered Nurse | Samuel Merritt College, 370 Hawthorne Ave, Oakland, CA 94609 | 2019-08-09 |
| 1396208286 | Graham Vallis | Student in an Organized Health Care Education/Training Program | Ucsf Benioff Children's Hospital Oakland, 747 52nd Street, Oakland, CA 94609 | 2019-04-09 |
| 1386129526 | Gary Mitchell Snider | Counselor | 390 40th Street, Oakland, CA 94609 | 2018-10-02 |
| 1720568389 | Lice Control Inc. | Technician | 6557 Shattuck Ave, Oakland, CA 94609 | 2018-08-14 |
| 1528559150 | Jenna Marie Kincaid | Behavior Technician | 400 29th St., 204, Oakland, CA 94609 | 2018-05-18 |
| 1336656669 | Nicholas Dicarlo | Social Worker | 465 34th St Ste 6, Oakland, CA 94609 | 2018-01-09 |
| 1174045744 | Theodora J Marzouk | Home Health Aide | 3317 Elm Street, Suite 202, Oakland, CA 94609 | 2017-07-14 |
| 1740728922 | Elena Gardella | Marriage & Family Therapist | 411 30th Street, Suite 412, Oakland, CA 94609 | 2017-02-07 |
| Find all providers in zip 94609 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639777386 | Jonathan Josue Grijalva | Nurse Practitioner | 1909 White Feather Loop, Oakland, FL 34787-8127 | 2020-10-14 |
| 1790313047 | Macy Sun | Nurse Practitioner | 1806 9th Ave, Oakland, CA 94606-3020 | 2020-03-31 |
| 1073157756 | Theola J Rivera | Nurse Practitioner | 889 Wynstone Cir N, Oakland, MI 48363-1605 | 2019-11-05 |
| 1326692211 | Shanna Lee | Nurse Practitioner | 35 Buena Vista Pl, Oakland, CA 94618-2132 | 2019-07-29 |
| 1184287682 | Kristine Dionne Williams | Nurse Practitioner | 3847 Rhoda Ave, Oakland, CA 94602-3322 | 2019-04-19 |
| 1346702404 | Whitney Karr | Nurse Practitioner | 65 Thousand Oaks St, Oakland, CA 94605-4618 | 2019-04-05 |
| 1982104360 | Brandi Sue Paugh | Nurse Practitioner | 241 N 4th St, Oakland, MD 21550-1375 | 2018-02-13 |
| 1164930533 | Brookside Health & Wellness LLC | Nurse Practitioner | 6500 Thayer Center, Oakland, MD 21550-1116 | 2018-01-18 |
| 1356870315 | Ayelet Cohen | Nurse Practitioner | 333 Park View Ter Apt 2, Oakland, CA 94610-4646 | 2017-06-05 |
| 1679014534 | Priscilla Beach Brown | Nurse Practitioner | 138 Monte Cresta Ave Apt 206, Oakland, CA 94611-4805 | 2017-03-12 |
| Find all providers in OAKLAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.