Healthcare Provider Details

I. General information

NPI: 1306331483
Provider Name (Legal Business Name): LINGJIN ZHENG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2018
Last Update Date: 07/22/2024
Certification Date: 07/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2633 E 27TH ST
OAKLAND CA
94601-1912
US

IV. Provider business mailing address

2302 VALDEZ ST APT 522
OAKLAND CA
94612-3198
US

V. Phone/Fax

Practice location:
  • Phone: 510-535-5115
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number2018017150
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: