Provider Demographics
NPI:1184902603
Name:RINGOLD-GRAHAM, CASSANDRA ELISE
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:ELISE
Last Name:RINGOLD-GRAHAM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4239 BAY ST APT 322
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-4247
Mailing Address - Country:US
Mailing Address - Phone:510-979-1208
Mailing Address - Fax:
Practice Address - Street 1:39155 LIBERTY ST STE E500
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-1516
Practice Address - Country:US
Practice Address - Phone:510-459-6797
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-02
Last Update Date:2011-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program