Healthcare Provider Details

I. General information

NPI: 1801637558
Provider Name (Legal Business Name): NEDA JAVADI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/05/2024
Last Update Date: 09/10/2025
Certification Date: 09/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

747 52ND ST
OAKLAND CA
94609-1809
US

IV. Provider business mailing address

3015 SAN PABLO AVE APT 215
BERKELEY CA
94702-2490
US

V. Phone/Fax

Practice location:
  • Phone: 510-428-3885
  • Fax: 510-601-3913
Mailing address:
  • Phone: 951-751-5341
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: