Organization
ON CALL PROVIDER SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHARONNE ELAINE ROGERS FNP (CEO)
(510) 325-1734
Entity
Organization
Contact information
Practice address
2321 86TH AVE, OAKLAND, CA 94605-3907
(510) 325-1734
(510) 562-6493
Mailing address
2321 86TH AVE, OAKLAND, CA 94605-3907
(510) 325-1734
(510) 562-6493
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
14579
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1003009275
NPI
CA
Enumeration date
08/04/2016
Last updated
08/04/2016
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