MEDICARE: ADEBOWALE ARSHAD NURSE PRACTITIONER

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	834153	CA
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	95003802	CA

General Provider Information

NPI Number	:	1821405283
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADEBOWALE ARSHAD NURSE PRACTITIONER

Provider Business Mailing Address
First Line	:	1404 FRANKLIN ST STE 200
Second Line	:
City	:	OAKLAND
State	:	CA
Zip	:	94612-3208
Country	:	US
Telephone Number	:	415-535-3310
Fax Number	:	510-601-3973

Provider Business Practice Location Address
First Line	:	1404 FRANKLIN ST STE OAKLAND
Second Line	:
City	:	OAKLAND
State	:	CA
Zip	:	94612-3210
Country	:	US
Telephone Number	:	415-535-3310
Fax Number	:

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

Provider Enumeration Date	:	07/17/2014
Last Update Date	:	06/17/2025

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