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General NPI Number Information
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NPI Number | 1881241073
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Entity Type | Individual
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Provider Name | CAITLYN OFALLA-HERNANDO
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Gender | Female
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Dates
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Enumeration Date | 08/22/2019
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Last Update Date | 06/08/2025
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Provider Practice Location Address
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Address Line | 166 SANTA CLARA AVE STE 205
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City | OAKLAND
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State | CA
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Zip | 94610-1323
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Country | US
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Telephone | 510-601-1929
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Fax | 510-601-1947
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Provider Business Mailing Address
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Address Line | 1236 WALKER AVE APT 112
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City | WALNUT CREEK
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State | CA
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Zip | 94596-4840
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Country | US
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Telephone | 408-823-2728
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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