Healthcare Provider Details

I. General information

NPI: 1154656064
Provider Name (Legal Business Name): BARBARA DEAN WHITE-JONES FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: BARBARA DEAN WHITE FNP

II. Dates (important events)

Enumeration Date: 10/09/2009
Last Update Date: 05/07/2021
Certification Date: 05/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 ADELINE ST
OAKLAND CA
94607
US

IV. Provider business mailing address

700 ADELINE ST
OAKLAND CA
94607
US

V. Phone/Fax

Practice location:
  • Phone: 510-835-9610
  • Fax: 510-225-2314
Mailing address:
  • Phone: 510-835-9610
  • Fax: 510-225-2314

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number283996
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: