Healthcare Provider Details

I. General information

NPI: 1720305600
Provider Name (Legal Business Name): ROBYN SERA NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2010
Last Update Date: 03/08/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10700 MACARTHUR BLVD SUITE 14B
OAKLAND CA
94605-5298
US

IV. Provider business mailing address

2344 6TH STREET ATTENTION: CREDENTIALING DEPT.
BERKELEY CA
94710
US

V. Phone/Fax

Practice location:
  • Phone: 510-563-4300
  • Fax: 510-563-4384
Mailing address:
  • Phone: 510-563-4300
  • Fax: 510-553-2169

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number661634
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: