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Individual

CAITLIN HANAVAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN, FNP-C

Contact information

Practice address
3451 E 12TH ST, OAKLAND, CA 94601-3463
(510) 535-3500
Mailing address
PO BOX 22210, OAKLAND, CA 94623-2210
(510) 535-4000
(510) 535-4189

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
740098
NY
363L00000X
Nurse Practitioner
Primary
95015134
CA
363LF0000X
Family Nurse Practitioner
F344494
NY

Other

Enumeration date
04/17/2019
Last updated
08/02/2021
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