Individual
KENNETH EMANUEL BAPTISTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
390 40TH ST, OAKLAND, CA 94609-2633
(510) 613-0330
Mailing address
390 40TH ST, OAKLAND, CA 94609-2633
(510) 613-0330
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MPSS-EVPCWZ
CA
175T00000X
Peer Specialist
Primary
MPSS-EVPCWZ
CA
Other
Enumeration date
01/23/2026
Last updated
02/15/2026
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