Basic Information
| Provider Information | |||||||||
| NPI: | 1942740832 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | SOLLEDER | ||||||||
| FirstName: | ANGELA | ||||||||
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| Credential: | FNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3000 COLBY ST | ||||||||
| Address2: | UNIT 201 | ||||||||
| City: | BERKELEY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 947052083 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5108430692 | ||||||||
| FaxNumber: | 5108433230 | ||||||||
| Practice Location | |||||||||
| Address1: | 395 OYSTER POINT BLVD STE 512 | ||||||||
| Address2: | |||||||||
| City: | SOUTH SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 940801973 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6508262945 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/27/2017 | ||||||||
| LastUpdateDate: | 08/26/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/26/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 516558 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.