Healthcare Provider Details

I. General information

NPI: 1659628014
Provider Name (Legal Business Name): MERLE HEALER HHA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/04/2012
Last Update Date: 08/04/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2296 COUNTRY DR
FREMONT CA
94536-5315
US

IV. Provider business mailing address

2296 COUNTRY DR
FREMONT CA
94536-5315
US

V. Phone/Fax

Practice location:
  • Phone: 510-797-9299
  • Fax: 510-795-4739
Mailing address:
  • Phone: 510-797-9299
  • Fax: 510-795-4739

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: