1871796581 NPI number — MS. EILEEN MARGARET HEALY CNS

Table of content: MS. EILEEN MARGARET HEALY CNS (NPI 1871796581)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871796581 NPI number — MS. EILEEN MARGARET HEALY CNS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HEALY
Provider First Name:
EILEEN
Provider Middle Name:
MARGARET
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
CNS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1871796581
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/15/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3300 WEBSTER ST STE 702
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OAKLAND
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94609-3122
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
510-549-4220
Provider Business Mailing Address Fax Number:
510-433-0744

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
15 ALTARINDA RD STE 112
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ORINDA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94563-2607
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-549-4220
Provider Business Practice Location Address Fax Number:
510-433-0744
Provider Enumeration Date:
06/08/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163W00000X , with the licence number:  200383 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 364S00000X , with the licence number: 1314 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: RN200383 . This is a "CLINICAL NURSE SPECIALIST" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com