Healthcare Provider Details

I. General information

NPI: 1992626238
Provider Name (Legal Business Name): LUZ LORENA BUSTAMANTE-MENDEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1451 28TH AVE
OAKLAND CA
94601-1632
US

IV. Provider business mailing address

2820 GARDEN ST APT B
OAKLAND CA
94601-1343
US

V. Phone/Fax

Practice location:
  • Phone: 510-830-8790
  • Fax:
Mailing address:
  • Phone: 510-830-8790
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: