Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 14779 | CA |
N | 363L00000X | Nurse Practitioner | 448089 | CA |
NPI | 1003023946 |
---|---|
Provider Name | Ms. Karen Gold |
First Address | Oakland, CA 94623-2210 |
Second Address | San Lorenzo, CA 94580-1732 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2007 |
Last Update Date | 23/08/2013 |