Provider Demographics
NPI:1962734269
Name:MAKONI, BESSA HOPE (NP)
Entity type:Individual
Prefix:MS
First Name:BESSA
Middle Name:HOPE
Last Name:MAKONI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39500 LIBERTY ST
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-2211
Mailing Address - Country:US
Mailing Address - Phone:510-770-8133
Mailing Address - Fax:510-770-8142
Practice Address - Street 1:39500 LIBERTY ST
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-2211
Practice Address - Country:US
Practice Address - Phone:510-770-8133
Practice Address - Fax:510-770-8142
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-11
Last Update Date:2014-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19090363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner