Healthcare Provider Details

I. General information

NPI: 1689264863
Provider Name (Legal Business Name): QUEST NURSING HEALTH CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/21/2021
Last Update Date: 01/21/2021
Certification Date: 01/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

917 HARRISON ST
OAKLAND CA
94607-4424
US

IV. Provider business mailing address

917 HARRISON ST
OAKLAND CA
94607-4424
US

V. Phone/Fax

Practice location:
  • Phone: 510-689-6830
  • Fax:
Mailing address:
  • Phone: 510-689-6830
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: STACEY ELETU
Title or Position: ADMINISTRATOR
Credential:
Phone: 510-689-6830