Healthcare Provider Details

I. General information

NPI: 1942734744
Provider Name (Legal Business Name): ALMA DEPIZZO FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2017
Last Update Date: 08/02/2020
Certification Date: 08/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39500 LIBERTY ST
FREMONT CA
94538-2211
US

IV. Provider business mailing address

550 DEEP VALLEY DR STE 319
ROLLING HILLS ESTATES CA
90274-7604
US

V. Phone/Fax

Practice location:
  • Phone: 510-770-8040
  • Fax:
Mailing address:
  • Phone: 310-977-0624
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95006366
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: