Individual
JODI MOONBEAM OLDFATHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
280 W MACARTHUR BLVD, OAKLAND, CA 94611-5642
(510) 752-1000
Mailing address
280 W MACARTHUR BLVD, DEPARTMENT OF ANESTHESIA, OAKLAND, CA 94611-5642
(510) 752-6238
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4160
CA
Other
Enumeration date
01/31/2012
Last updated
01/03/2022
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