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Individual
MERY JIEN OMAN
Active
Individual
MERY JIEN OMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
21333
CA
363LF0000X
Family Nurse Practitioner
21333
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1033418785
—
CA
01
—
FE354A
MEDICARE
CA
05
—
GR0083640
—
CA
05
—
GR0083641
—
CA
01
—
ZZZ19972Z
MEDICARE LEGACY NUMBER
CA
01
—
ZZZ20075Z
MEDICARE LEGACY NUMBER
CA
Enumeration date
07/05/2012
Last updated
01/16/2024
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