Healthcare Provider Details

I. General information

NPI: 1174729826
Provider Name (Legal Business Name): LORI SUZANNE SALEMI RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

280 W MACARTHUR BLVD
OAKLAND CA
94611-5642
US

IV. Provider business mailing address

280 W MACARTHUR BLVD
OAKLAND CA
94611-5642
US

V. Phone/Fax

Practice location:
  • Phone: 510-752-2525
  • Fax: 510-752-2910
Mailing address:
  • Phone: 510-752-2525
  • Fax: 510-752-2910

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number543036
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: