Provider Information for 1437784949
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DEANGELA COOKS
Sex: Female
NPI: 1437784949
Last Updated: 2024-10-24
Certification Date: 2024-10-22
Certification Date: 2024-10-22
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1437784949 | ||||||||
| Enumeration Date | 2020-03-04 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 130 CENTER ST SUITE 200 BERKELEY, CA 94704 United States Phone: 510-548-8283 | Fax:510-548-2938 | ||||||||
| Primary Practice Address | 130 CENTER ST SUITE 200 BERKELEY, CA 94704 United States Phone: 510-548-8283 | Fax:510-548-2938 | ||||||||
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