Healthcare Provider Details

I. General information

NPI: 1205655842
Provider Name (Legal Business Name): NEWBORN NIRVANA, A NURSING CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2024
Last Update Date: 10/09/2024
Certification Date: 10/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6429 SHELTERWOOD DR
OAKLAND CA
94611-1601
US

IV. Provider business mailing address

6429 SHELTERWOOD DR
OAKLAND CA
94611-1601
US

V. Phone/Fax

Practice location:
  • Phone: 415-279-6978
  • Fax:
Mailing address:
  • Phone: 415-279-6978
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number
License Number State

VIII. Authorized Official

Name: STEPHANIE ORLOFF
Title or Position: CLINICAL DIRECTOR
Credential: BC-FNP, IBCLC
Phone: 415-279-6978