MRS. KRISTEN TYSELL GHOUSSAINI PNP NPI 1104068444

NPI Information

NPI: 1104068444
Provider Name: MRS. KRISTEN TYSELL GHOUSSAINI, PNP
Classification: Nurse Practitioner - 363LP0200X
Entity Type: Individual

Specialization: Pediatrics

PECOS Registration: Yes

Address:
744 52ND ST
SUITE 5203
OAKLAND, CA
ZIP 94609
Phone: (510) 428-3319
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MRS. Kristen Tysell Ghoussaini, PNP is a pediatrics nurse practitioner in Oakland, CA. MRS. Kristen Tysell Ghoussaini, PNP NPI is 1104068444. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

744 52ND ST
SUITE 5203
OAKLAND, CA
ZIP 94609-810
Phone: (510) 428-3319
Fax: (510) 597-7034

The NPI 1104068444 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/1/2009 and was last updated on 4/3/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LP0200X	Nurse Practitioner	Pediatrics	382047	NEW YORK	No
2	363LP0200X	Nurse Practitioner	Pediatrics	21230	CALIFORNIA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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