Healthcare Provider Details

I. General information

NPI: 1013840339
Provider Name (Legal Business Name): ROSA SALAZAR LVN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2026
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1124 INTERNATIONAL BLVD
OAKLAND CA
94606-4331
US

IV. Provider business mailing address

1124 INTERNATIONAL BLVD
OAKLAND CA
94606-4331
US

V. Phone/Fax

Practice location:
  • Phone: 510-533-0800
  • Fax: 510-533-0300
Mailing address:
  • Phone: 510-533-0800
  • Fax: 510-533-0300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number722870
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: