MS. JERUSALEM MAKONNEN (NPI# 1972510022) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972510022 |
| Entity Type | Individual |
| Full Name | MS. JERUSALEM MAKONNEN |
| Credential | RN,MSN,FNP |
| Practice Address |
3850 Grand Ave Oakland CA 94610-1004 |
| Mailing Address |
130 Sutter St Fl 2 San Francisco CA 94104-4009 |
| Practice Telephone | 5102251013 |
| Mailing Telephone | 4156586791 |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2017-03-31 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
8911 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
3850 GRAND AVE |
| City | OAKLAND |
| State | CA |
| Zip Code | 94610-1004 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639106610 | Divya T Raj | Family Medicine | 3850 Grand Ave, Oakland, CA 94610 | 2006-06-27 |
| 1154738755 | Katherine Murray | Nurse Practitioner | 3850 Grand Ave, Oakland, CA 94610-1004 | 2014-07-15 |
| 1740626571 | Katharine Peterson | Family Medicine | 3850 Grand Ave, Oakland, CA 94610-1004 | 2013-05-20 |
| 1104168236 | Jessica A Miller | Family Medicine | 3850 Grand Ave, Oakland, CA 94610-1004 | 2013-03-27 |
| 1548556707 | Nina P Patel | Family Medicine | 3850 Grand Ave, Oakland, CA 94610-1004 | 2011-06-24 |
| 1790088318 | Sarit Silver | Pediatrics | 3850 Grand Ave, Oakland, CA 94610-1004 | 2010-12-21 |
| 1104141282 | Vaibhav Arun Medhekar | Internal Medicine | 3850 Grand Ave, Oakland, CA 94610 | 2010-04-01 |
| 1831333780 | Joanna Mandell | Family Medicine | 3850 Grand Ave, Oakland, CA 94610-1004 | 2009-04-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467944033 | Danielle Elissa Comerford | Marriage & Family Therapist | 370 Grand Ave Ste 4, Oakland, CA 94610 | 2018-05-30 |
| 1073042628 | Thien Lake Acupuncture | Clinic/Center | 3654 Grand Aveune, Oakland, CA 94610 | 2017-06-07 |
| 1508239302 | Montserrat Corsino | Acupuncturist | 493 Prince St, Oakland, CA 94610 | 2015-11-03 |
| 1376978593 | Mazen Abudllah Basidiq | Registered Nurse | 271 Jayne Ave. Suite # 11, Oakland, CA 94610 | 2013-09-06 |
| 1740523026 | Katiah Llerena | Psychologist | 414 Lake Park Ave, #595, Oakland, CA 94610 | 2013-04-04 |
| 1033459409 | Shelly Lynn Henderson-hansen | Speech-Language Pathologist | 3756 Grand Ave, Suite 401, Oakland, CA 94610 | 2013-02-22 |
| 1013267806 | Sara-jean Lizabeth Bartky | Speech-Language Pathologist | 55 Santa Clara Ave #203, Oakland, CA 94610 | 2012-09-19 |
| 1053667139 | Juanita Lerma Hernandez-morin | Counselor | 1375 55th Street, Emeryville, CA 94610 | 2012-07-26 |
| 1396030672 | Catherine Maness | Marriage & Family Therapist | 123 Bay Place, Ste 6, Oakland, CA 94610 | 2011-06-14 |
| 1871807529 | Jaime Beth Levy | Marriage & Family Therapist | 1001 Warfield Ave Apt 103, Oakland, CA 94610 | 2010-08-04 |
| Find all providers in zip 94610 | ||||
| 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 | ||||
Please comment or provide details below to improve the information on MS. JERUSALEM MAKONNEN.
| 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.