Provider Demographics
NPI:1841051604
Name:GULAQA, NASER (LVN)
Entity type:Individual
Prefix:
First Name:NASER
Middle Name:
Last Name:GULAQA
Suffix:
Gender:M
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3162 WASHOE WAY
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94588-4027
Mailing Address - Country:US
Mailing Address - Phone:510-941-8005
Mailing Address - Fax:
Practice Address - Street 1:3162 WASHOE WAY
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588-4027
Practice Address - Country:US
Practice Address - Phone:510-941-8005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-18
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA716562164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse