Healthcare Provider Details

I. General information

NPI: 1043842198
Provider Name (Legal Business Name): SENEGBEH MUSU GBAKAMARA NPS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/06/2020
Last Update Date: 09/05/2025
Certification Date: 09/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

747 52ND ST
OAKLAND CA
94609-1809
US

IV. Provider business mailing address

242 CARLYN CT
DOWNINGTOWN PA
19335-4202
US

V. Phone/Fax

Practice location:
  • Phone: 510-428-3885
  • Fax:
Mailing address:
  • Phone: 484-340-0513
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberSP030848
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: