Mary Ahmadi

Individual provider Active NPI Licensed Vocational Nurse · Fremont, CA

NPI 1003083452 · NPPES record last updated May 14, 2008

Key facts

NPI
1003083452
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Vocational Nurse 164X00000X
License
128189 (CA)
Practice address
2296 Country Dr
Fremont, CA 94536-5315
Phone
(510) 792-3555
Fax
(510) 797-7205
NPI assigned
May 14, 2008
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
128189CAMDLicensed Vocational Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X 128189 CA Yes

Addresses

Primary practice location

2296 Country Dr
Fremont, CA 94536-5315

Mailing address

2296 Country Dr
Fremont, CA 94536-5315
Phone (510) 792-3555

Other providers in Fremont, CA

All providers in Fremont, CA · Licensed Vocational Nurse in California

Sources for this page

Verify at the official NPI Registry.