Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jenny Ta Pettersen, FNP

Individual provider Family Nurse Practitioner · NPI 1780016097

Jenny Ta Pettersen, FNP is a Nurse Practitioner in Oakland, California. Qualified in 2013, 13 years ago. Practices with Northeast Valley Health Corporation, a 76-clinician group. Licensed in California.

Years since qualifying
13
Licensed in
CA
In the registry since
2013
Specialties on file
2
What do these letters mean?
FNP — Family Nurse Practitioner
A nurse practitioner who treats patients of all ages, much like a family doctor.

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Practice location Address checks out

818 Webster St
Oakland, CA 94607-4220
Phone: (510) 986-6800
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 23448 (CA)
Registered Nurse Taxonomy 163W00000X · Licence 757451 (CA)

Record details

NPI number1780016097
Entity typeIndividual (Type 1)
GenderFemale
Credentials FNP
Sole proprietorYes
NPI enumeratedAugust 8, 2013
Last updated in NPPESApril 9, 2017

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2013 (13 years in practice)
Group practice Northeast Valley Health Corporation — 76 clinicians
Accepts Medicare assignment Not indicated

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