Individual provider · Type 1 NPI

Kristen Tysell Ghoussaini, PNP

Pediatric Nurse Practitioner · Oakland, CA

NPI number 1104068444 Active

Practice location

747 52nd St
Oakland, CA 94609-1809

Mailing address

744 52nd St, Suite 5203
Oakland, CA 94609-1810

Other practice locations

  • 744 52nd St, Suite 5203, Oakland, CA 94609-1810 · (510) 428-3319

Specialties and licenses

TaxonomyCodeLicense
Pediatric Nurse Practitioner Primary 363LP0200X21230 (CA)
Pediatric Nurse Practitioner 363LP0200X382047 (NY)

Pediatric Nurse Practitioner: Definition to come...

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About NPI 1104068444

Kristen Tysell Ghoussaini, PNP's National Provider Identifier is 1104068444, issued on Apr 1, 2009. The primary taxonomy on file is Pediatric Nurse Practitioner (363LP0200X), and the practice location is in Oakland, CA. The record was last updated on Jul 25, 2025.