Provider Demographics
NPI:1811249329
Name:HO, NINA Y (NP-C)
Entity type:Individual
Prefix:
First Name:NINA
Middle Name:Y
Last Name:HO
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:NINA
Other - Middle Name:Y
Other - Last Name:HO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP-C
Mailing Address - Street 1:3100 TELEGRAPH AVE
Mailing Address - Street 2:SUITE 3105
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609-3239
Mailing Address - Country:US
Mailing Address - Phone:510-879-9263
Mailing Address - Fax:510-457-2627
Practice Address - Street 1:3100 TELEGRAPH AVE
Practice Address - Street 2:SUITE 3105
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-3239
Practice Address - Country:US
Practice Address - Phone:510-869-6511
Practice Address - Fax:510-869-6212
Is Sole Proprietor?:No
Enumeration Date:2012-10-08
Last Update Date:2022-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP95001381390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program