Individual
MS. D'ANGELA LATREACE WATKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
280 17TH ST, OAKLAND, CA 94612-4124
(510) 238-5020
Mailing address
280 17TH ST, OAKLAND, CA 94612-4124
(510) 238-5020
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
A1983074
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1411033663
EMPLOYER ID NUMBER
CA
Enumeration date
04/07/2008
Last updated
04/07/2008
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