Healthcare Provider Details

I. General information

NPI: 1023880358
Provider Name (Legal Business Name): LARREI MAY ARAZA DAVID
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/30/2023
Last Update Date: 10/30/2023
Certification Date: 10/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1411 E 31ST ST
OAKLAND CA
94602-1018
US

IV. Provider business mailing address

1411 E 31ST ST
OAKLAND CA
94602-1092
US

V. Phone/Fax

Practice location:
  • Phone: 510-437-6478
  • Fax: 510-437-5173
Mailing address:
  • Phone: 510-437-6478
  • Fax: 510-437-6478

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WW0101X
TaxonomyAmbulatory Women's Health Care Registered Nurse
License Number95172631
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: