Provider Demographics
NPI:1144378902
Name:GERSTEN-ROTHENBERG, KAREN L (MSN, RN, NPF)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:L
Last Name:GERSTEN-ROTHENBERG
Suffix:
Gender:F
Credentials:MSN, RN, NPF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 22210
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94623-2210
Mailing Address - Country:US
Mailing Address - Phone:510-535-4000
Mailing Address - Fax:510-535-4189
Practice Address - Street 1:1390 66TH AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94621-3506
Practice Address - Country:US
Practice Address - Phone:510-639-1981
Practice Address - Fax:510-632-8225
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2013-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20085363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFHC71087FMedicaid
CAFHC71087FMedicaid
ZZZ29799ZMedicare PIN