Healthcare Provider Details

I. General information

NPI: 1902231202
Provider Name (Legal Business Name): MISHAFFNER LYNN JONES RN, MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2013
Last Update Date: 09/09/2023
Certification Date: 09/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 MERCED ST
SAN LEANDRO CA
94577-4201
US

IV. Provider business mailing address

29916 LARRABEE ST
HAYWARD CA
94544-6808
US

V. Phone/Fax

Practice location:
  • Phone: 510-454-1000
  • Fax:
Mailing address:
  • Phone: 650-515-8084
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code224Y00000X
TaxonomyClinical Exercise Physiologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License Number3842
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number781341
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: