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Individual

STEPHANIE MARIE ONG DE LEON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
A-GNP-C

Contact information

Practice address
250 E 18TH ST FL 2, OAKLAND, CA 94606-1716
(510) 735-3888
Mailing address
818 WEBSTER ST, OAKLAND, CA 94607-4220
(510) 986-6800

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
95222645
CA
363LA2200X
Adult Health Nurse Practitioner
AG07200182
CA
363LG0600X
Gerontology Nurse Practitioner
Primary
95016216
CA

Other

Enumeration date
09/11/2020
Last updated
03/29/2022
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