Individual
TANYA KAILATH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
GNP-BC
Contact information
Practice address
10690 SAN PABLO AVE, EL CERRITO, CA 94530-2620
(916) 813-5212
Mailing address
10690 SAN PABLO AVE # CA, EL CERRITO, CA 94530-2620
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
19491
CA
363LP2300X
Primary Care Nurse Practitioner
277871
MA
Other
Enumeration date
12/01/2009
Last updated
12/05/2024
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