Individual
KELLY JIA LI FANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
818 WEBSTER ST, OAKLAND, CA 94607-4220
(510) 986-6800
Mailing address
2225 CLINTON AVE, ALAMEDA, CA 94501-4927
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
788618
CA
Other
Enumeration date
09/04/2019
Last updated
09/04/2019
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