Provider Demographics
NPI:1508274812
Name:CHERNOFF, JOSEPHINE
Entity Type:Individual
Prefix:MS
First Name:JOSEPHINE
Middle Name:
Last Name:CHERNOFF
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:JOSEPHINE
Other - Middle Name:MARY
Other - Last Name:PRYAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:4324 SALEM ST
Mailing Address - Street 2:A
Mailing Address - City:EMERYVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94608-3301
Mailing Address - Country:US
Mailing Address - Phone:510-381-3248
Mailing Address - Fax:
Practice Address - Street 1:510 17TH ST
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94612-1553
Practice Address - Country:US
Practice Address - Phone:510-318-7132
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-30
Last Update Date:2014-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA663090163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse