Healthcare Provider Details

I. General information

NPI: 1659089654
Provider Name (Legal Business Name): NINA GOLUBSKI FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/08/2022
Last Update Date: 04/24/2023
Certification Date: 04/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2625 SHADELANDS DR
WALNUT CREEK CA
94598-2512
US

IV. Provider business mailing address

2625 SHADELANDS DR
WALNUT CREEK CA
94598-2512
US

V. Phone/Fax

Practice location:
  • Phone: 925-939-8585
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95022257
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: