Healthcare Provider Details

I. General information

NPI: 1952239915
Provider Name (Legal Business Name): CAROL AYUMI HARDY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

162 VIA DEL SOL
WALNUT CREEK CA
94597-1865
US

IV. Provider business mailing address

162 VIA DEL SOL
WALNUT CREEK CA
94597-1865
US

V. Phone/Fax

Practice location:
  • Phone: 628-217-5800
  • Fax:
Mailing address:
  • Phone: 628-217-5800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number95053380
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: