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General NPI Number Information
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NPI Number | 1750716221
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Entity Type | Organization
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Legal Business Name | SAINT MARY'S COLLEGE OF CALIFORNIA
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Dates
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Enumeration Date | 09/03/2013
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Last Update Date | 02/06/2014
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Provider Practice Location Address
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Address Line | 1928 SAINT MARYS RD
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City | MORAGA
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State | CA
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Zip | 94556-2715
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Country | US
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Telephone | 925-457-2050
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Fax |
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Provider Business Mailing Address
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Address Line | 487 FAIRBANKS AVE
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City | OAKLAND
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State | CA
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Zip | 94610-1507
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Country | US
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Telephone | 925-457-2050
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | RACHEL GARCIA
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Credential |
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Telephone | 925-457-2050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 23548
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License Number State | CA
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