Healthcare Provider Details

I. General information

NPI: 1326494337
Provider Name (Legal Business Name): BLESSING LAWSKI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/09/2016
Last Update Date: 07/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 BROADWAY
OAKLAND CA
94612-2141
US

IV. Provider business mailing address

5674 STONERIDGE DR STE 207
PLEASANTON CA
94588-8592
US

V. Phone/Fax

Practice location:
  • Phone: 510-273-4200
  • Fax:
Mailing address:
  • Phone: 925-520-0005
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number739966
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95006433
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95006433
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: