Healthcare Provider Details

I. General information

NPI: 1811249329
Provider Name (Legal Business Name): NINA Y HO NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NINA Y HO NP-C

II. Dates (important events)

Enumeration Date: 10/08/2012
Last Update Date: 04/29/2022
Certification Date: 04/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 TELEGRAPH AVE SUITE 3105
OAKLAND CA
94609-3239
US

IV. Provider business mailing address

3100 TELEGRAPH AVE SUITE 3105
OAKLAND CA
94609-3239
US

V. Phone/Fax

Practice location:
  • Phone: 510-869-6511
  • Fax: 510-869-6212
Mailing address:
  • Phone: 510-879-9263
  • Fax: 510-457-2627

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberNP95001381
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: