Healthcare Provider Details

I. General information

NPI: 1508586736
Provider Name (Legal Business Name): ALISON HORTON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2022
Last Update Date: 08/29/2022
Certification Date: 08/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

747 52ND ST
OAKLAND CA
94609-1859
US

IV. Provider business mailing address

747 52ND ST
OAKLAND CA
94609-1859
US

V. Phone/Fax

Practice location:
  • Phone: 510-428-3000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0222X
TaxonomyCritical Care Pediatric Nurse Practitioner
License Number95018804
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: