Individual
BEANVA FAIRMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
700 ADELINE ST, OAKLAND, CA 94607-2608
(510) 835-9610
(510) 900-8830
Mailing address
935 FILBERT ST, OAKLAND, CA 94607-3111
(510) 435-2413
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
739873
CA
Other
Enumeration date
01/02/2025
Last updated
01/02/2025
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