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Wisal Fare, PA-C
Adult Health Clinical Nurse Specialist in San Leandro, California
NPI 1578525598

Wisal Fare is an Adult Health Clinical Nurse Specialist based in Antioch, CA and is specialized in Adult Health. Wisal Fare practices in San Leandro, CA and has the professional credentials of PA-C. The NPI Number for Wisal Fare is 1578525598 and holds a License No. PA13725 (California).

The current practice location address for Wisal Fare is 13851 E 14Th St, San Leandro, CA and can be reached out via phone at 510-351-1193 and via fax at 510-351-6456.

Location: 13851 E 14Th St, San Leandro, CA, 94531-8811
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Provider Profile Details
NPI Number
1578525598
Provider Name
Wisal Fare
Credential
PA-C
Provider Entity Type
Individual
Gender
Female
Address
13851 E 14Th St, San Leandro, CA, 94531-8811
Phone Number
510-351-1193
Fax Number
510-351-6456
Provider Enumeration Date
04/05/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
110006522 01 CA PTAN
ZZZ15328Z 01 CA PTAN
institution
Provider Business Practice Location Address Details
Address
13851 E 14Th St
City
State
Zip
94578-2631
Phone Number
510-351-1193
Fax Number
510-351-6456
person
Provider Business Mailing Address Details
Address
13851 E 14Th St
City
State
Zip
94578-2631
Phone Number
510-351-1193
Fax Number
510-351-6456
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Clinical Nurse Specialist
Speciality
Adult Health
Taxonomy
License No.
PA13725 (California)
Definition
Definition to come...
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