Provider Demographics
NPI:1871659961
Name:WESTOBY, MELANIE ANN (CRNA)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:ANN
Last Name:WESTOBY
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:MELANIE
Other - Middle Name:ANN
Other - Last Name:WESTOBY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CRNA
Mailing Address - Street 1:275 W MACARTHUR BLVD
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94611-5641
Mailing Address - Country:US
Mailing Address - Phone:510-752-6238
Mailing Address - Fax:
Practice Address - Street 1:275 W MACARTHUR BLVD
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94611-5641
Practice Address - Country:US
Practice Address - Phone:510-752-6238
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-31
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2401367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAP66477Medicare UPIN