Healthcare Provider Details

I. General information

NPI: 1013030568
Provider Name (Legal Business Name): REBECCA EVE MENASHE CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2007
Last Update Date: 11/10/2025
Certification Date: 11/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3701 BROADWAY
OAKLAND CA
94611-5613
US

IV. Provider business mailing address

1 KAISER PLZ
OAKLAND CA
94612-3610
US

V. Phone/Fax

Practice location:
  • Phone: 510-752-4092
  • Fax:
Mailing address:
  • Phone: 510-752-4092
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number621297
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number1695
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number116036
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: