Individual
MR. EBONY ANDRE MANUEL JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
1080 MARINA VILLAGE PKWY, ALAMEDA, CA 94501-6427
(510) 337-7950
Mailing address
2750 NAPLES ST, HAYWARD, CA 94545-3412
(510) 681-4075
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
95183771
CA
Other
Enumeration date
07/15/2024
Last updated
07/15/2024
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