Provider Demographics
NPI:1689264863
Name:QUEST NURSING HEALTH CLINIC
Entity Type:Organization
Organization Name:QUEST NURSING HEALTH CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:STACEY
Authorized Official - Middle Name:
Authorized Official - Last Name:ELETU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-689-6830
Mailing Address - Street 1:917 HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94607-4424
Mailing Address - Country:US
Mailing Address - Phone:510-689-6830
Mailing Address - Fax:
Practice Address - Street 1:917 HARRISON ST
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94607-4424
Practice Address - Country:US
Practice Address - Phone:510-689-6830
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-21
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care