Healthcare Provider Details

I. General information

NPI: 1003226325
Provider Name (Legal Business Name): BARBARA MOCNIK APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2014
Last Update Date: 05/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 GRANT RD
MOUNTAIN VIEW CA
94040-4302
US

IV. Provider business mailing address

2500 GRANT ROAD EL CAMINO HOSPITAL
MOUNTAIN VIEW CA
94040
US

V. Phone/Fax

Practice location:
  • Phone: 650-940-7187
  • Fax: 650-962-5715
Mailing address:
  • Phone: 650-940-7187
  • Fax: 650-962-5715

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number180746
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: