Healthcare Provider Details

I. General information

NPI: 1255388237
Provider Name (Legal Business Name): DIANE ELIZABETH STRAUS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/27/2006
Last Update Date: 01/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3260 SACRAMENTO ST
BERKELEY CA
94702-2739
US

IV. Provider business mailing address

3260 SACRAMENTO ST
BERKELEY CA
94702-2739
US

V. Phone/Fax

Practice location:
  • Phone: 510-428-4526
  • Fax: 510-428-4594
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number15624
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: