Most Relevant Information
Provider Data
| NPI Number: | 1003580887 |
| Provider Name: | KAYLA JOANNE DOUGLAS |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/04/2021 |
| Last Updated: | 08/04/2021 |
Provider Practice Location
3800 COOLIDGE AVE
OAKLAND
CA
946023311
Practice Location Phone/Fax
| Phone: | 5104822244 |
| Fax: | 5104881960 |
Provider Mailing Location
3800 COOLIDGE AVE
OAKLAND
CA
946023311
Provider Mailing Phone/Fax
| Phone: | 5104822244 |
| Fax: | 5104881960 |