PINE PARK HEALTH, INC
NPI 1346879848
Internal Medicine in Berkeley, CA

Q: What is Pine Park Health, Inc's NPI number?

The NPI number for Pine Park Health, Inc is 1346879848. It was assigned to this organization in the NPPES registry on April 6, 2020.

Q: What is Pine Park Health, Inc's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Active since April 06, 2020CLIA Certified · 2 labs

1901 4TH ST STE 201, BERKELEY, CA 94710(510) 929-1400(510) 929-1414 Get Directions Write a Review

NPPES record last updated: February 4, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Feb 4, 2025, Sep 7, 2023, Oct 14, 2022 and 4 more (7 updates tracked since 2020).

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About Pine Park Health, Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PINE PARK HEALTH, INC (NPI 1346879848) is a healthcare organization registered as an internal medicine in Berkeley, California and active in the NPI registry since April 2020. The organization holds 2 active CLIA laboratory certificates, maintains 6 additional practice locations, and lists Stephanie Vanzee, Credentialing Coordinator, as its authorized official.

NPPES Registry Identity

NPI1346879848

Entity TypeOrganization

Primary Taxonomy207R00000X

Legal Business NamePINE PARK HEALTH, INC

Location Address1901 4TH ST STE 201Berkeley, CA 94710-1986

Mailing AddressPo Box 511250Los Angeles, CA 90051-7805 · (510) 929-1400 · Fax (510) 929-1414

Phone(510) 929-1400

Fax(510) 929-1414

Organization SubpartNo

Authorized OfficialStephanie VanzeeCredentialing Coordinator · (469) 401-8820

Enumeration DateApril 6, 2020

Last NPPES UpdateFebruary 4, 20257 updates tracked since enumeration

NPPES CertifiedFebruary 4, 2025

✔ NPI 1346879848 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 11

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Also ListedFamily MedicineTaxonomy 207Q00000X

Also ListedFamily Medicine · Adult MedicineTaxonomy 207QA0505X

Also ListedFamily Medicine · Geriatric MedicineTaxonomy 207QG0300X

Also ListedPhysician AssistantTaxonomy 363A00000X

Also ListedNurse PractitionerTaxonomy 363L00000X

Also ListedNurse Practitioner · Acute CareTaxonomy 363LA2100X

Also ListedNurse Practitioner · Adult HealthTaxonomy 363LA2200X

Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X

Also ListedNurse Practitioner · GerontologyTaxonomy 363LG0600X

Also ListedNurse Practitioner · Primary CareTaxonomy 363LP2300X

1901 4TH ST STE 201, Berkeley, CA 94710

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Secondary Practice Locations 6

Location 116977 Healdsburg AveHealdsburg, CA 95448-3261 · Phone (510) 929-1400 · Fax (510) 929-1414

Location 29800 Glen Center DrSan Diego, CA 92131-1686 · Phone (858) 832-2500 · Fax (858) 400-3023

Location 32645 E Southern AveTempe, AZ 85282-7649 · Phone (623) 624-8280 · Fax (602) 835-0192

Location 44500 Gilbert StOakland, CA 94611-4657 · Phone (510) 929-1400 · Fax (510) 929-1414

Location 519303 N New Tradition RdSun City West, AZ 85375-3806 · Phone (623) 624-8280 · Fax (602) 835-0192

Location 6501 Via CasitasGreenbrae, CA 94904-1901 · Phone (510) 929-1400 · Fax (510) 929-1414

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 03D2269060

Pine Park Health · Sun City West, AZ

Active · expires Sep 19, 2026

CLIA Number03D2269060

Laboratory TypeTesting In Alf

Certificate Effective DateSeptember 20, 2024

Certificate Expiration DateSeptember 19, 2026

Laboratory DirectorCannon M. Kendall

Laboratory Phone(510) 929-1400

Laboratory LocationPine Park Health19303 N New Tradition Rd, Sun City West, AZ 85375

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 05D2191945

Pine Park Health Inc · Oakland, CA

Active · expires Sep 1, 2026

CLIA Number05D2191945

Laboratory TypeAssisted Living Facility

Certificate Effective DateSeptember 2, 2024

Certificate Expiration DateSeptember 1, 2026

Laboratory DirectorKendell Cannon

Laboratory Phone(510) 929-1400

Laboratory LocationPine Park Health Inc1144 65th St, Suite F, Oakland, CA 94608

CLIA data matches this NPI record on: Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

AMANDA MARIE ILAG AGNP

Nurse Practitioner (Primary Care)