Most Relevant Information
Provider Data
| NPI Number: | 1003681727 |
| Provider Name: | ANNIE ROQUE |
| Entity Type: | Individual |
| Taxonomy Code: | 363LP0200X |
| Specialty: | Nurse Practitioner |
| License Number: | 95000457 |
Most Important Dates
| Enumeration Date: | 11/22/2023 |
| Last Updated: | 11/22/2023 |
Provider Practice Location
747 52ND ST
OAKLAND
CA
946091809
Practice Location Phone/Fax
| Phone: | 5104284418 |
| Fax: |
Provider Mailing Location
1428 BONITA AVE
BERKELEY
CA
947091909
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |