Provider Demographics
NPI:1467231456
Name:WEETE, NINA
Entity Type:Individual
Prefix:
First Name:NINA
Middle Name:
Last Name:WEETE
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 1:2667 MEADOW GLEN DR
Mailing Address - Street 2:
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94583-1819
Mailing Address - Country:US
Mailing Address - Phone:510-209-9315
Mailing Address - Fax:
Practice Address - Street 1:2667 MEADOW GLEN DR
Practice Address - Street 2:
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-1819
Practice Address - Country:US
Practice Address - Phone:510-209-9315
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-27
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker