Healthcare Provider Details

I. General information

NPI: 1396341038
Provider Name (Legal Business Name): IWATA NURSING ANESTHESIA SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2020
Last Update Date: 07/24/2025
Certification Date: 07/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2163 ALDENGATE WAY # 422
HAYWARD CA
94545-3527
US

IV. Provider business mailing address

416B MAIN ST
SALINAS CA
93901-3306
US

V. Phone/Fax

Practice location:
  • Phone: 415-942-4743
  • Fax: 831-783-3089
Mailing address:
  • Phone: 831-800-7887
  • Fax: 831-998-7155

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: MS. ERIKO IWATA
Title or Position: CRNA
Credential: CRNA
Phone: 415-942-4743