Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 258119 | MA |
NPI | 1013218551 |
---|---|
Provider Name | Dr. Kayla Enriquez |
First Address | Oakland, CA 94602-1018 |
Second Address | Oakland, CA 94602-1018 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/11/2010 |
Last Update Date | 06/06/2014 |