Individual
MARY E THIES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA, MSNA
Contact information
Practice address
3600 BROADWAY, OAKLAND, CA 94611-5730
(510) 752-1000
Mailing address
PO BOX 1324, EL CERRITO, CA 94530-1324
(509) 998-8590
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
95109953
CA
367500000X
Certified Registered Nurse Anesthetist
Primary
95002199
CA
Other
Enumeration date
08/25/2008
Last updated
09/27/2023
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