Healthcare Provider Details

I. General information

NPI: 1962976597
Provider Name (Legal Business Name): CORA GARCIA NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/16/2019
Last Update Date: 05/11/2020
Certification Date: 05/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2950 INTERNATIONAL BLVD
OAKLAND CA
94601-2228
US

IV. Provider business mailing address

2950 INTERNATIONAL BLVD
OAKLAND CA
94601-2228
US

V. Phone/Fax

Practice location:
  • Phone: 510-381-2683
  • Fax:
Mailing address:
  • Phone: 510-535-4400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95012650
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95138229
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: