Individual
MELLANY ANN AQUINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
3100 SUMMIT ST, OAKLAND, CA 94609-3412
(510) 428-3885
Mailing address
290 PACIFICA DR, BRENTWOOD, CA 94513-1394
(650) 455-1562
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
95013266
CA
Other
Enumeration date
11/19/2019
Last updated
11/19/2019
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