Healthcare Provider Details

I. General information

NPI: 1346394590
Provider Name (Legal Business Name): JANET GRAUL R.N., P.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5220 CLAREMONT AVE
OAKLAND CA
94618-1033
US

IV. Provider business mailing address

5220 CLAREMONT AVE
OAKLAND CA
94618-1033
US

V. Phone/Fax

Practice location:
  • Phone: 510-428-3129
  • Fax: 510-547-2702
Mailing address:
  • Phone: 510-428-3129
  • Fax: 510-547-2702

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number257620
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: