Basic Information
| Provider Information | |||||||||
| NPI: | 1548228208 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FLORES | ||||||||
| FirstName: | PATRICIA | ||||||||
| MiddleName: | IRMA | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 365 HAWTHORNE AVE | ||||||||
| Address2: | STE 301 | ||||||||
| City: | OAKLAND | ||||||||
| State: | CA | ||||||||
| PostalCode: | 946093113 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5108931700 | ||||||||
| FaxNumber: | 5108930110 | ||||||||
| Practice Location | |||||||||
| Address1: | 365 HAWTHORNE AVE | ||||||||
| Address2: | STE 301 | ||||||||
| City: | OAKLAND | ||||||||
| State: | CA | ||||||||
| PostalCode: | 946093113 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5108931700 | ||||||||
| FaxNumber: | 5108930110 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/03/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | RN217578 | CA | X | Nursing Service Providers | Registered Nurse | 363L00000X | NP4139 | CA | X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.