Provider Demographics
NPI:1093382533
Name:MINGMING, AUBRY
Entity Type:Individual
Prefix:
First Name:AUBRY
Middle Name:
Last Name:MINGMING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1903 IRVING AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94601-1131
Mailing Address - Country:US
Mailing Address - Phone:510-507-9129
Mailing Address - Fax:
Practice Address - Street 1:1903 IRVING AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94601-1131
Practice Address - Country:US
Practice Address - Phone:510-507-9129
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-04
Last Update Date:2021-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA716446164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse