Basic Information
| Provider Information | |||||||||
| NPI: | 1669550802 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | VERANO | ||||||||
| FirstName: | WENDY | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | P.A.-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3300 WEBSTER ST | ||||||||
| Address2: | SUITE 500 | ||||||||
| City: | OAKLAND | ||||||||
| State: | CA | ||||||||
| PostalCode: | 946093117 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5104656600 | ||||||||
| FaxNumber: | 5104656600 | ||||||||
| Practice Location | |||||||||
| Address1: | 3300 WEBSTER ST | ||||||||
| Address2: | SUITE 500 | ||||||||
| City: | OAKLAND | ||||||||
| State: | CA | ||||||||
| PostalCode: | 946093117 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5104656600 | ||||||||
| FaxNumber: | 5108390806 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/02/2006 | ||||||||
| LastUpdateDate: | 01/03/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AS0400X | 25MP00171900 | NJ | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Surgical |
No ID Information.