Individual
CARYN JILL GOTTCENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NPF
Contact information
Practice address
3451 E 12TH STREET, OAKLAND, CA 94601
(510) 535-3319
(510) 535-4187
Mailing address
1601 FRUITVALE AVE, OAKLAND, CA 94601-2322
(510) 535-4000
(510) 535-4128
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
NPF13559
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
55-1975
FQHC MEDICARE PART A
CA
05
—
FHC71021F
—
CA
01
—
HAP71021F
FPACT
CA
01
—
ZZZ29799Z
FQHC MEDICARE PART B
CA
Enumeration date
09/06/2006
Last updated
07/10/2010
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