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Individual

TAISA GRANT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3200 ADELINE ST, BERKELEY, CA 94703-2407
(510) 601-0203
(510) 601-4002
Mailing address
3200 ADELINE ST, BERKELEY, CA 94703-2407
(510) 601-0203
(510) 601-4002

Taxonomy

Speciality
Code
Description
License number
State
246Y00000X
Health Information Specialist/Technologist
Primary
CA
246Y00000X
Health Information Specialist/Technologist

Other

Enumeration date
05/29/2018
Last updated
05/29/2018
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