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General NPI Number Information
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NPI Number | 1255056388
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Entity Type | Individual
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Provider Name | VICTORIA UHATAFE
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Gender | Female
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Dates
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Enumeration Date | 10/11/2022
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Last Update Date | 10/14/2024
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Provider Practice Location Address
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Address Line | 1605 JEFFERSON ST
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City | OAKLAND
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State | CA
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Zip | 94612-1215
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Country | US
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Telephone | 510-923-1099
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Fax | 510-350-8793
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Provider Business Mailing Address
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Address Line | 1121 40TH ST
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City | EMERYVILLE
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State | CA
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Zip | 94608-3600
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Country | US
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Telephone | 727-967-3765
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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 | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 720128
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License Number State | CA
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