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General NPI Number Information
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NPI Number | 1831233964
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Entity Type | Organization
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Legal Business Name | KAISER PERMANENTE
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Dates
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Enumeration Date | 02/20/2007
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Last Update Date | 09/30/2008
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Provider Practice Location Address
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Address Line | 975 SERENO DR
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City | VALLEJO
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State | CA
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Zip | 94589-2441
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Country | US
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Telephone | 707-651-3581
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Fax |
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Provider Business Mailing Address
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Address Line | 877 CHANNING CIR
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City | BENICIA
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State | CA
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Zip | 94510-3638
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CLINICAL NURSE MANAGER
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Name | DIANE HILDEBRANDT
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Credential |
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Telephone | 707-651-3581
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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