Healthcare Provider Details

I. General information

NPI: 1114858602
Provider Name (Legal Business Name): SPECIALIZED WOUND SOLUTIONS APC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3920 NEVIL ST
OAKLAND CA
94601-3824
US

IV. Provider business mailing address

3920 NEVIL ST
OAKLAND CA
94601-3824
US

V. Phone/Fax

Practice location:
  • Phone: 510-290-0317
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: LINDA WHITEMAN
Title or Position: ADMINISTRATOR
Credential:
Phone: 530-663-8031