Provider Demographics
NPI:1649497736
Name:GAMMAD, NATIVIDAD AGUINALDO (RN)
Entity type:Individual
Prefix:
First Name:NATIVIDAD
Middle Name:AGUINALDO
Last Name:GAMMAD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:679 LISBON ST
Mailing Address - Street 2:
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94014-2772
Mailing Address - Country:US
Mailing Address - Phone:650-367-1890
Mailing Address - Fax:650-369-6465
Practice Address - Street 1:200 EDMONDS RD
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94062-3813
Practice Address - Country:US
Practice Address - Phone:650-367-1890
Practice Address - Fax:650-369-6465
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA493228163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse