Organization
KAISER PERMANENTE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE HILDEBRANDT (CLINICAL NURSE MANAGER)
(707) 651-3581
Entity
Organization
Contact information
Practice address
975 SERENO DR, VALLEJO, CA 94589-2441
(707) 651-3581
Mailing address
877 CHANNING CIR, BENICIA, CA 94510-3638
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
493610
CAL RN LICENSE
CA
Enumeration date
02/20/2007
Last updated
09/30/2008
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