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General NPI Number Information
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NPI Number | 1043008386
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Entity Type | Individual
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Provider Name | MS. ELYSSA TUCAY ACOB
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Gender | Female
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Dates
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Enumeration Date | 04/28/2025
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Last Update Date | 04/28/2025
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Provider Practice Location Address
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Address Line | 500 PACIFIC AVE
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City | ALAMEDA
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State | CA
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Zip | 94501-2125
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Country | US
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Telephone | 510-748-4024
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Fax |
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Provider Business Mailing Address
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Address Line | 4549 NILAND ST
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City | UNION CITY
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State | CA
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Zip | 94587-5446
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Country | US
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Telephone | 510-364-9034
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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License Number |
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License Number State | CA
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