KRISTIN K MANCUSO


Address: 1411 E 31st St, Oakland, CA 94602-1018
Phone: 2093422300

KRISTIN K MANCUSO (NPI# 1306824669) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1306824669
Entity Type Individual
Full Name KRISTIN K MANCUSO
Other Name KRISTIN K MALDONADO
Credential PA
Practice Address 1411 E 31st St
Oakland
CA 94602-1018
Mailing Address 4301 Northstar Way
Modesto
CA 95356-9262
Practice Telephone 2093422300
Practice Fax Number 2095244240
Mailing Telephone 2093422300
Mailing Fax Number 2095244240
Enumeration Date 2006-01-06
Last Update Date 2007-07-08
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 364SE0003X Clinical Nurse Specialist
Specialization: Emergency
PA16054 CA Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
CA OPA160540 05

Office Location

Street Address 1411 E 31ST ST
City OAKLAND
State CA
Zip Code 94602-1018

Providers in the same location

NPI Name Taxonomy Address Enumeration
1396733135 Andrea Elizabeth Williams Family Medicine 1411 E 31st St, Oakland, CA 94602-1018 2005-10-06
1972101186 Jennifer Pham Pharmacist 1411 E 31st St, Oakland, CA 94602-1018 2020-10-12
1922606276 Monica Mofidi Registered Nurse 1411 E 31st St, Oakland, CA 94602-1018 2020-10-09
1639785223 Mercedeh Nicole Vaez Dentist 1411 E 31st St, Oakland, CA 94602-1018 2020-09-18
1962015701 Egbe Iyabo Omoregie Nurse Practitioner 1411 E 31st St, Oakland, CA 94602-1018 2020-08-30
1275146672 Jessica Labioda Sohn Social Worker 1411 E 31st St, Oakland, CA 94602-1018 2020-08-25
1760093462 Himalina Rajanakhan Registered Nurse 1411 E 31st St, Oakland, CA 94602-1092 2020-08-14
1316558018 Lisa De La Cruz Registered Nurse 1411 E 31st St, Oakland, CA 94602-1018 2020-08-14
1396356762 Jermaine Robertson Student in an Organized Health Care Education/Training Program 1411 E 31st St, Oakland, CA 94602-1018 2020-08-11
1700496437 Kathleen Puanani Hennessy Pharmacist 1411 E 31st St, Oakland, CA 94602-1018 2020-08-06
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1376151845 Nicholas Collins Pac Lac Inc Acupuncturist 3433 Brunell Dr, Oakland, CA 94602 2020-07-21
1225667850 Elaine Dellinger Student in an Organized Health Care Education/Training Program Highland Hospital 1411 East 31st Street, Qic 22123, Oakland, CA 94602 2020-04-06
1356804033 Jayakala Lakireddy Student in an Organized Health Care Education/Training Program Dept of Surgery, 1411 East 31st Street, Oakland, CA 94602 2019-04-10
1750844585 Kirea J Mazzolini Student in an Organized Health Care Education/Training Program Dept. of Surgery, 1411 East 31st Street, Oakland, CA 94602 2019-04-09
1912478587 Joie Mazor Chiropractor 3201 Macarthur Blvd., Oakland, CA 94602 2018-12-07
1114424884 Jesse Santos Student in an Organized Health Care Education/Training Program Dept. of Surgery, 1411 East 31st Street, Oakland, CA 94602 2018-04-10
1679078646 Tia Vang Student in an Organized Health Care Education/Training Program 1411 E. 31st Street 2nd Flr A2, Oakland, CA 94602 2018-03-29
1942704101 Michael Mian Student in an Organized Health Care Education/Training Program 1411 E 31st St, Qic 22123, Oakland, CA 94602 2018-03-22
1063916575 Charisma Kaushik Student in an Organized Health Care Education/Training Program 1411 East 31st Street, Qic 22123, Oakland, CA 94602 2018-03-20
1841711363 David Christopher Carroll Pharmacist 1411 E. 31st Street, Oakland, CA 94602 2017-07-06
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Taxonomy Information

Taxonomy Code 364SE0003X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Clinical Nurse Specialist
Specialization Emergency

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1134188501 Joshua Salome Inez Luftig Clinical Nurse Specialist 1411 East 31 Street, Oakland, CA 94602-1018 2006-03-22
1215986732 Brandon Lee Shulman Clinical Nurse Specialist 1411 East 31st Street, Oakland, CA 94602-1018 2006-05-10
1003887480 Patricia Scott Meyer Clinical Nurse Specialist 1411 E 31st St, Oakland, CA 94602-1018 2006-02-01
1326020397 Dana Lynne Kelly Clinical Nurse Specialist 1411 East 31st St, Oakland, CA 94602-1018 2005-11-16
1962483412 Kevin Lee Binder Clinical Nurse Specialist 1411 E 31st St, Oakland, CA 94602-1018 2005-11-10
1316928088 Richard Gerard Ochoa Clinical Nurse Specialist 1411 E 31st St, Oakland, CA 94602-1018 2005-11-09
1518958834 Susan Louise Glasscock Clinical Nurse Specialist 1411 E 31st St, Oakland, CA 94602-1018 2005-11-04
1194716415 Hillary Jane Larkin Clinical Nurse Specialist 1411 E 31st St, Oakland, CA 94602-1018 2005-11-04
1447241773 Martin Thomas Moran Clinical Nurse Specialist 1411 E 31st St, Oakland, CA 94602-1018 2005-11-04
1801887195 Denae Katina Reed Clinical Nurse Specialist 1411 E 31st St, Oakland, CA 94602-1018 2005-11-04
Find all providers in OAKLAND

Competitor

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City OAKLAND
Zip Code 94602

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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