Healthcare Provider Details

I. General information

NPI: 1093382533
Provider Name (Legal Business Name): AUBRY MINGMING
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2021
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1124 INTERNATIONAL BLVD
OAKLAND CA
94606-4331
US

IV. Provider business mailing address

2430 E 20TH ST
OAKLAND CA
94601-1111
US

V. Phone/Fax

Practice location:
  • Phone: 510-533-0800
  • Fax:
Mailing address:
  • Phone: 510-894-5128
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number716446
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: