Healthcare Provider Details

I. General information

NPI: 1841542651
Provider Name (Legal Business Name): DEANA HARRIS KILAT CNM, NP, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DEANA HARRIS

II. Dates (important events)

Enumeration Date: 10/04/2012
Last Update Date: 01/11/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1411 E 31ST ST # 4 ALAMEDA COUNTY MEDICAL CENTER-MEDICAL STAFF SERVICES
OAKLAND CA
94602-1018
US

IV. Provider business mailing address

1411 E 31ST ST
OAKLAND CA
94602-1018
US

V. Phone/Fax

Practice location:
  • Phone: 510-437-6535
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number778846
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number2010
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: