Provider Demographics
NPI:1740641869
Name:ANDINO, JOSEFINE
Entity type:Individual
Prefix:
First Name:JOSEFINE
Middle Name:
Last Name:ANDINO
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 1:7200 BANCROFT AVENUE
Mailing Address - Street 2:SUITE 269
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94605
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7200 BANCROFT AVE
Practice Address - Street 2:SUITE 269
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94605-2403
Practice Address - Country:US
Practice Address - Phone:510-746-1700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-17
Last Update Date:2016-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker