Healthcare Provider Details

I. General information

NPI: 1356205215
Provider Name (Legal Business Name): GABRIEL ANDREW NEOH RN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1411 E 31ST ST
OAKLAND CA
94602-1018
US

IV. Provider business mailing address

4161 CHURCHILL DR
PLEASANTON CA
94588-3518
US

V. Phone/Fax

Practice location:
  • Phone: 510-437-4800
  • Fax:
Mailing address:
  • Phone: 925-209-4693
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number95336469
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: