Healthcare Provider Details

I. General information

NPI: 1518101765
Provider Name (Legal Business Name): KAREN H MOSELEY DANBE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/30/2009
Last Update Date: 04/30/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 HARRISON ST 5TH FLOOR- 51R06
OAKLAND CA
94612-3466
US

IV. Provider business mailing address

1800 HARRISON ST 5TH FLOOR- 51R06
OAKLAND CA
94612-3466
US

V. Phone/Fax

Practice location:
  • Phone: 510-625-6651
  • Fax:
Mailing address:
  • Phone: 510-625-6651
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WA2000X
TaxonomyAdministrator Registered Nurse
License Number271523
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: