Healthcare Provider Details

I. General information

NPI: 1548850688
Provider Name (Legal Business Name): ADRIANA ABBA LEMON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/22/2021
Last Update Date: 05/28/2025
Certification Date: 05/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1005 ATLANTIC AVE
ALAMEDA CA
94501-1148
US

IV. Provider business mailing address

351 LAUREL AVE APT 22
HAYWARD CA
94541-7625
US

V. Phone/Fax

Practice location:
  • Phone: 415-474-7310
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: