Healthcare Provider Details

I. General information

NPI: 1346303773
Provider Name (Legal Business Name): KASI L PARRA NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2006
Last Update Date: 12/30/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 W MACARTHUR BLVD ATTN: RADIOLOGY DEPT
OAKLAND CA
94611-5641
US

IV. Provider business mailing address

275 W MACARTHUR BLVD ATTN: RADIOLOGY DEPT
OAKLAND CA
94611-5641
US

V. Phone/Fax

Practice location:
  • Phone: 510-752-2414
  • Fax:
Mailing address:
  • Phone: 510-752-2414
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number544140
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: