Healthcare Provider Details

I. General information

NPI: 1821538919
Provider Name (Legal Business Name): VANESSA ONYINYECHI OBIDIMALOR RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/08/2017
Last Update Date: 02/27/2026
Certification Date: 02/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2999 REGENT ST STE 524
BERKELEY CA
94705-2120
US

IV. Provider business mailing address

325 DISTEL CIR
LOS ALTOS CA
94022-1408
US

V. Phone/Fax

Practice location:
  • Phone: 510-495-0310
  • Fax: 510-244-0446
Mailing address:
  • Phone: 831-477-2375
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberCNM08373
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: