Provider Demographics
NPI:1871198820
Name:CONTI, LAKEETA SHEERIE (RN)
Entity Type:Individual
Prefix:
First Name:LAKEETA
Middle Name:SHEERIE
Last Name:CONTI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:LAKEETA
Other - Middle Name:SHEERIE
Other - Last Name:DANIELS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:6610 BANCROFT AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94605-2007
Mailing Address - Country:US
Mailing Address - Phone:419-699-7164
Mailing Address - Fax:
Practice Address - Street 1:6955 FOOTHILL BLVD STE 67A
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94605-2455
Practice Address - Country:US
Practice Address - Phone:510-626-4570
Practice Address - Fax:510-969-5840
Is Sole Proprietor?:No
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95053176163WI0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy