Provider Demographics
NPI:1710161146
Name:GARCIA, PAMELA GONZALEZ (RN)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:GONZALEZ
Last Name:GARCIA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:REYES
Other - Last Name:GONZALEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:2647 INTERNATIONAL BLVD
Mailing Address - Street 2:#600
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94601
Mailing Address - Country:US
Mailing Address - Phone:510-434-7588
Mailing Address - Fax:510-434-7908
Practice Address - Street 1:2647 INTERNATIONAL BLVD
Practice Address - Street 2:#600
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94601
Practice Address - Country:US
Practice Address - Phone:510-434-7588
Practice Address - Fax:510-434-7908
Is Sole Proprietor?:No
Enumeration Date:2007-12-20
Last Update Date:2007-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN533857163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse