Kelly, Dana Lynne

Kelly, Dana Lynne is an individual health care provider with primary practice located at 1411 East 31St St , Oakland CA 94602-1018. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Emergency, which is considered as her primary health care specialty. Kelly, Dana Lynne can be contacted via phone (209) 342-2300.

Contact Information

Primary practice address
1411 East 31St St Oakland CA 94602-1018
Phone: (209) 342-2300
Fax: (209) 524-4240
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Emergency 364SE0003X PA13877 California

Profile Details

NPI number 1326020397
LBN Legal business name Kelly, Dana Lynne
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 16th, 2005
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1326020397 NPPES
California MEDICAID 0PA138770

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