Individual provider · NPI-1

Anthony Abraham

Community Health Worker · Oakland, CA

NPI number1871109884
StatusActive
Last updated in NPPESSep 16, 2020

Details

NPI
1871109884
Entity type
Individual (NPI-1)
Name
Anthony Abraham
Sex
Male
Sole proprietor
No
Enumeration date
Sep 16, 2020
Certification date
Sep 16, 2020
Last updated
Sep 16, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
172V00000X Community Health Worker––Yes

Practice location

3301 E. 12th Street
Suite 259
Oakland, CA 94601

Phone 510-485-7417

Mailing address

3301 E. 12th Street
Suite 259
Oakland, CA 94601

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