Provider Demographics
NPI:1588440135
Name:HAENER, ANTONINA (FNP-C)
Entity type:Individual
Prefix:
First Name:ANTONINA
Middle Name:
Last Name:HAENER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:ANTONINA
Other - Middle Name:
Other - Last Name:BIAGINI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2000 MOWRY AVE
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-1746
Mailing Address - Country:US
Mailing Address - Phone:510-685-9742
Mailing Address - Fax:
Practice Address - Street 1:2000 MOWRY AVE
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-1746
Practice Address - Country:US
Practice Address - Phone:510-797-1111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-07
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA836060163W00000X
CA95026360363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse