Provider Demographics
NPI:1639624547
Name:PERCIA, DINA
Entity Type:Individual
Prefix:
First Name:DINA
Middle Name:
Last Name:PERCIA
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 1:42 CALIFORNIA AVE
Mailing Address - Street 2:
Mailing Address - City:ORINDA
Mailing Address - State:CA
Mailing Address - Zip Code:94563-2106
Mailing Address - Country:US
Mailing Address - Phone:310-562-2178
Mailing Address - Fax:
Practice Address - Street 1:2501 HARRISON ST
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94612-3811
Practice Address - Country:US
Practice Address - Phone:510-444-3344
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-20
Last Update Date:2016-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program