Provider Demographics
NPI:1881352086
Name:NDU, VERA
Entity type:Individual
Prefix:
First Name:VERA
Middle Name:
Last Name:NDU
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 1:1125 E 18TH ST APT 18
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94606-3833
Mailing Address - Country:US
Mailing Address - Phone:510-682-1410
Mailing Address - Fax:
Practice Address - Street 1:1125 E 18TH ST APT 18
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94606-3833
Practice Address - Country:US
Practice Address - Phone:510-682-1410
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-04
Last Update Date:2021-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN248621164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse