JENNY TA PETTERSEN FNP
NPI 1780016097
Nurse Practitioner - Family in Oakland, CA
About Jenny Ta Pettersen Fnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JENNY TA PETTERSEN FNP (NPI 1780016097) is an individual family provider in Oakland, California, licensed in California (23448) and active in the NPI registry since August 2013. She is enrolled in Medicare PECOS and is a graduate of Other (2013).
NPPES Registry Identity
Specialties & Licenses 2
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Jenny Ta Pettersen Fnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 94607 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Jenny Pettersen's NPI number?
The NPI number for Jenny Pettersen is 1780016097. It was assigned to this individual provider in the NPPES registry on August 8, 2013.
Where is Jenny Pettersen located?
Jenny Pettersen practices at 818 Webster St, Oakland, CA 94607. The listed phone number is (510) 986-6800.
What is Jenny Pettersen's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Jenny Pettersen enrolled in Medicare?
Yes. Jenny Pettersen is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for Jenny Pettersen was last updated on April 9, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Jenny Ta Pettersen, FNP · NPI 1780016097
Family physician in Oakland, California. Individual provider, active in the CMS NPPES registry since August 8, 2013.
## Identity
- **NPI:** 1780016097 (Entity type: Individual)
- **Enumerated:** August 8, 2013
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 23448 (California)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 818 WEBSTER ST, Oakland, CA 94607-4220
- **Phone:** (510) 986-6800
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Medical school:** Other, class of 2013
## Record status
- **NPPES last updated:** April 9, 2017
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Source: [NPI Profile](https://npiprofile.com/npi/1780016097) · Data from the CMS NPPES public registry.