Individual
DEBBIE TERRY CRUZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6333 TELEGRAPH AVE, OAKLAND, CA 94609-1359
(510) 407-4122
Mailing address
6333 TELEGRAPH AVE, OAKLAND, CA 94609-1359
(510) 407-4122
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000000111
—
CA
Enumeration date
08/11/2020
Last updated
11/27/2023
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