Healthcare Provider Details

I. General information

NPI: 1841554011
Provider Name (Legal Business Name): DIANA PATRICIA KOBAYASHI NNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. DIANA PATRICIA BRAUER

II. Dates (important events)

Enumeration Date: 07/02/2012
Last Update Date: 07/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 WELCH ROAD
PALO ALTO CA
94304-1117
US

IV. Provider business mailing address

725 WELCH ROAD
PALO ALTO CA
94304-1117
US

V. Phone/Fax

Practice location:
  • Phone: 650-497-8800
  • Fax: 650-497-8034
Mailing address:
  • Phone: 650-497-8800
  • Fax: 650-497-8034

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License Number9767
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: