Healthcare Provider Details

I. General information

NPI: 1932829587
Provider Name (Legal Business Name): GRACE GAI HUANG TARNOW NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2022
Last Update Date: 07/21/2025
Certification Date: 07/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 SIERRA ROAD
CONCORD CA
94518
US

IV. Provider business mailing address

2000 SIERRA ROAD
CONCO CA
94518
US

V. Phone/Fax

Practice location:
  • Phone: 925-363-2000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95022355
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: