Healthcare Provider Details

I. General information

NPI: 1932210812
Provider Name (Legal Business Name): JANE ANN NEWHARD-PARKS FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3050 CALIFORNIA ST
OAKLAND CA
94602-3908
US

IV. Provider business mailing address

3050 CALIFORNIA ST
OAKLAND CA
94602-3908
US

V. Phone/Fax

Practice location:
  • Phone: 510-531-1031
  • Fax: 510-531-0352
Mailing address:
  • Phone: 510-531-1031
  • Fax: 510-531-0352

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberFNP11403
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: