Basic Information
| Provider Information | |||||||||
| NPI: | 1194355446 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BIRNBAUM | ||||||||
| FirstName: | EMILY | ||||||||
| MiddleName: | HUNTER | ||||||||
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| Credential: | FNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5800 HOLLIS ST | ||||||||
| Address2: | |||||||||
| City: | EMERYVILLE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 946082016 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5108062100 | ||||||||
| FaxNumber: | 5108062548 | ||||||||
| Practice Location | |||||||||
| Address1: | 5800 HOLLIS ST | ||||||||
| Address2: | |||||||||
| City: | EMERYVILLE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 946082016 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5108062100 | ||||||||
| FaxNumber: | 5108062548 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/24/2020 | ||||||||
| LastUpdateDate: | 06/13/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 06/13/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | NP95013597 | CA | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 363L00000X | 95013597 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.