Healthcare Provider Details

I. General information

NPI: 1144145236
Provider Name (Legal Business Name): KIT YING YVONNE RUATHAIWAT MSN, RN, CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: YVONNE RUATHAIWAT MSN, RN, CNS

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

818 WEBSTER ST
OAKLAND CA
94607-4220
US

IV. Provider business mailing address

818 WEBSTER ST
OAKLAND CA
94607-4220
US

V. Phone/Fax

Practice location:
  • Phone: 510-986-6880
  • Fax:
Mailing address:
  • Phone: 510-986-6880
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number650766
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License Number2990
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code364SG0600X
TaxonomyGerontology Clinical Nurse Specialist
License Number2008006670
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: