MEDICARE: ZHANETTA VAYSMAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	489977	CA

General Provider Information

NPI Number	:	1629284815
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ZHANETTA VAYSMAN

Provider Business Mailing Address
First Line	:	16 INVINCIBLE CT # B36
Second Line	:
City	:	ALAMEDA
State	:	CA
Zip	:	94501-1055
Country	:	US
Telephone Number	:	510-769-1319
Fax Number	:

Provider Business Practice Location Address
First Line	:	1890 ALCATRAZ AVE
Second Line	:
City	:	BERKELEY
State	:	CA
Zip	:	94703-2715
Country	:	US
Telephone Number	:	510-601-0167
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/15/2007
Last Update Date	:	07/08/2007

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Directions to “ ZHANETTA VAYSMAN ” Practice Location

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