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NPI 1073716171

NPI 1073716171 : MARLENE DOLORES AKIN CDE : SAN JOSE, CA

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General NPI Number Information
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    NPI Number           |    1073716171
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    Entity Type          |    Individual 
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    Provider Name        |    MARLENE DOLORES AKIN CDE
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    06/06/2007
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    750 S BASCOM AVE DIABETES EDUCATION
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    City                 |    SAN JOSE
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    State                |    CA
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    Zip                  |    95128-2603
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    Country              |    US
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    Telephone            |    408-885-5000
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1600 HICKORY CT 
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    City                 |    HOLLISTER
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    State                |    CA
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    Zip                  |    95023-7511
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    Country              |    US
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    Telephone            |    831-636-6553
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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        |    163WN1003X
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    Taxonomy Name        |    Nutrition Support Registered Nurse
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    License Number       |    RN493621
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    License Number State |    CA
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