Healthcare Provider Details

I. General information

NPI: 1225764640
Provider Name (Legal Business Name): BESAN NIDAL ZARO FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2022
Last Update Date: 03/12/2023
Certification Date: 08/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39500 LIBERTY ST
FREMONT CA
94538-2211
US

IV. Provider business mailing address

39500 LIBERTY ST
FREMONT CA
94538-2211
US

V. Phone/Fax

Practice location:
  • Phone: 510-770-8040
  • Fax:
Mailing address:
  • Phone: 559-940-2031
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95021340
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: