Healthcare Provider Details

I. General information

NPI: 1710284096
Provider Name (Legal Business Name): MARTHA EPPENBERGER FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/22/2011
Last Update Date: 04/12/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

738 BANCROFT RD
WALNUT CREEK CA
94598-1531
US

IV. Provider business mailing address

738 BANCROFT RD
WALNUT CREEK CA
94598-1531
US

V. Phone/Fax

Practice location:
  • Phone: 925-938-8525
  • Fax:
Mailing address:
  • Phone: 925-938-8525
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number19190
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: