Provider Demographics
NPI:1891848990
Name:GUNARTO, VANINA (FNP-BC, RN, PHN, CNS)
Entity Type:Individual
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First Name:VANINA
Middle Name:
Last Name:GUNARTO
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Gender:F
Credentials:FNP-BC, RN, PHN, CNS
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Mailing Address - Street 1:1411 E 31ST ST
Mailing Address - Street 2:HIGHLAND GENERAL HOSPITAL - ADULT MEDICINE CLINIC K6A
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94602-1018
Mailing Address - Country:US
Mailing Address - Phone:510-437-5039
Mailing Address - Fax:510-535-7313
Practice Address - Street 1:1411 E 31ST ST
Practice Address - Street 2:HIGHLAND GENERAL HOSPITAL - ADULT MEDICINE CLINIC K6A
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94602-1018
Practice Address - Country:US
Practice Address - Phone:510-437-5039
Practice Address - Fax:510-535-7313
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2012-01-03
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Provider Licenses
StateLicense IDTaxonomies
CARN#613509 NP#14787363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily