Individual
MATTHEW KUBASTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NURSE PRACTITIONER
Contact information
Practice address
1420 WILLOW PASS RD, CONCORD, CA 94520
(925) 646-5480
Mailing address
231 AVOCADO PL, BRENTWOOD, CA 94513-1908
(510) 760-4803
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
9501588
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/08/2019
Last updated
12/20/2021
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