Healthcare Provider Details

I. General information

NPI: 1417155136
Provider Name (Legal Business Name): KAREN CORTESE-DUENAS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1451 28TH AVE
OAKLAND CA
94601-1632
US

IV. Provider business mailing address

1503 BANCROFT CT
SAN LEANDRO CA
94578-1745
US

V. Phone/Fax

Practice location:
  • Phone: 510-261-9191
  • Fax: 510-533-5630
Mailing address:
  • Phone: 510-499-7574
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number391701
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: