Healthcare Provider Details

I. General information

NPI: 1437333028
Provider Name (Legal Business Name): PAMELA GONZALEZ GARCIA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/19/2007
Last Update Date: 12/19/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2647 INTERNATIONAL BLVD STE 600
OAKLAND CA
94601-1562
US

IV. Provider business mailing address

2647 INTERNATIONAL BLVD STE 600
OAKLAND CA
94601-1562
US

V. Phone/Fax

Practice location:
  • Phone: 510-434-7588
  • Fax: 510-434-7908
Mailing address:
  • Phone: 510-434-7588
  • Fax: 510-434-7908

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberRN533857
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: