Provider Demographics
NPI:1730131715
Name:VEERHUSEN, NANCY (PA)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:
Last Name:VEERHUSEN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10700 MACARTHUR BLVD
Mailing Address - Street 2:EAST OAKLAND CLINIC, SUITE 14B
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94605-5260
Mailing Address - Country:US
Mailing Address - Phone:510-563-4327
Mailing Address - Fax:
Practice Address - Street 1:10700 MACARTHUR BLVD
Practice Address - Street 2:EAST OAKLAND CLINIC, SUITE 14B
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94605-5260
Practice Address - Country:US
Practice Address - Phone:510-563-4327
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2012-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11765363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAS41323Medicare UPIN