Provider Demographics
NPI:1962917377
Name:MASSELLA HERNANDEZ, MARIA EUGENIA (NP)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:EUGENIA
Last Name:MASSELLA HERNANDEZ
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:3451 E. 12TH STREET
Mailing Address - Street 2:FAMILY MEDICINE DEPARTMENT, ADMINISTRATION
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94601
Mailing Address - Country:US
Mailing Address - Phone:510-535-3500
Mailing Address - Fax:510-535-4225
Practice Address - Street 1:3451 E. 12TH STREET
Practice Address - Street 2:FAMILY MEDICINE DEPARTMENT, ADMINISTRATION
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94601
Practice Address - Country:US
Practice Address - Phone:510-535-3500
Practice Address - Fax:510-535-4225
Is Sole Proprietor?:No
Enumeration Date:2017-12-07
Last Update Date:2017-12-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA95007332207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine