Healthcare Provider Details

I. General information

NPI: 1609161132
Provider Name (Legal Business Name): ARIELLA JESSEL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/13/2011
Last Update Date: 02/21/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5501 CLAREMONT AVE APT B
OAKLAND CA
94618-1181
US

IV. Provider business mailing address

2100 POWELL ST STE 900
EMERYVILLE CA
94608-1844
US

V. Phone/Fax

Practice location:
  • Phone: 949-887-9806
  • Fax:
Mailing address:
  • Phone: 510-851-7423
  • Fax: 510-879-9120

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number20241
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: