=====================================================
General NPI Number Information
=====================================================
NPI Number | 1629925052
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | HILINA KEBEDE
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/13/2026
-----------------------------------------------------
Last Update Date | 03/13/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1850 FAIRWAY DR
-----------------------------------------------------
City | SAN LEANDRO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94577-5629
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 510-746-0510
-----------------------------------------------------
Fax | 510-746-0977
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5648 BAY ST APT 410
-----------------------------------------------------
City | EMERYVILLE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94608-2423
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163W00000X
-----------------------------------------------------
Taxonomy Name | Registered Nurse
-----------------------------------------------------
License Number | 95301451
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------