Healthcare Provider Details

I. General information

NPI: 1497273775
Provider Name (Legal Business Name): VERONICA ANDREA GARCIA RN, MSN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2017
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2633 E 27TH ST
OAKLAND CA
94601-1912
US

IV. Provider business mailing address

1148 MISSION AVE
SAN RAFAEL CA
94901-2915
US

V. Phone/Fax

Practice location:
  • Phone: 510-536-8111
  • Fax:
Mailing address:
  • Phone: 860-966-4919
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number802143
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF06171274
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: