Healthcare Provider Details

I. General information

NPI: 1871796581
Provider Name (Legal Business Name): EILEEN MARGARET HEALY CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2007
Last Update Date: 05/15/2024
Certification Date: 05/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 ALTARINDA RD STE 112
ORINDA CA
94563-2607
US

IV. Provider business mailing address

3300 WEBSTER ST STE 702
OAKLAND CA
94609-3122
US

V. Phone/Fax

Practice location:
  • Phone: 510-549-4220
  • Fax: 510-433-0744
Mailing address:
  • Phone: 510-549-4220
  • Fax: 510-433-0744

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number200383
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License Number1314
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: