Healthcare Provider Details

I. General information

NPI: 1427372101
Provider Name (Legal Business Name): MANTON SCOTT HURD N.P.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2010
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

298 GRAND AVE STE 101
OAKLAND CA
94610-4895
US

IV. Provider business mailing address

616 16TH ST
OAKLAND CA
94612-1205
US

V. Phone/Fax

Practice location:
  • Phone: 510-550-5486
  • Fax: 510-937-3619
Mailing address:
  • Phone: 510-981-4100
  • Fax: 510-937-3619

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number836388
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95004842
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: