Healthcare Provider Details

I. General information

NPI: 1639855018
Provider Name (Legal Business Name): NIGEENA MOHSINI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/22/2023
Last Update Date: 11/14/2024
Certification Date: 11/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 LINDEN ST
OAKLAND CA
94607-2538
US

IV. Provider business mailing address

150 LINDEN ST
OAKLAND CA
94607-2538
US

V. Phone/Fax

Practice location:
  • Phone: 510-273-4700
  • Fax:
Mailing address:
  • Phone: 510-273-4700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: