Individual
CASSANDRA BROADWAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2280 SAN PABLO AVE, OAKLAND, CA 94612-1321
(510) 807-4390
Mailing address
1204 E 15TH ST, OAKLAND, CA 94606-3806
(510) 807-4390
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
—
—
Other
Enumeration date
02/07/2023
Last updated
02/07/2023
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