Provider Demographics
NPI:1891200622
Name:TIMALSINA, BIBEK
Entity Type:Individual
Prefix:
First Name:BIBEK
Middle Name:
Last Name:TIMALSINA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:554 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94610-3515
Mailing Address - Country:US
Mailing Address - Phone:510-444-1671
Mailing Address - Fax:
Practice Address - Street 1:554 GRAND AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94610-3515
Practice Address - Country:US
Practice Address - Phone:510-698-2604
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-01
Last Update Date:2023-12-12
Deactivation Date:2021-02-22
Deactivation Code:
Reactivation Date:2021-08-20
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical