Provider Demographics
NPI:1871796581
Name:HEALY, EILEEN MARGARET (CNS)
Entity type:Individual
Prefix:MS
First Name:EILEEN
Middle Name:MARGARET
Last Name:HEALY
Suffix:
Gender:F
Credentials:CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 WEBSTER ST STE 702
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609-3122
Mailing Address - Country:US
Mailing Address - Phone:510-549-4220
Mailing Address - Fax:510-433-0744
Practice Address - Street 1:15 ALTARINDA RD STE 112
Practice Address - Street 2:
Practice Address - City:ORINDA
Practice Address - State:CA
Practice Address - Zip Code:94563-2607
Practice Address - Country:US
Practice Address - Phone:510-549-4220
Practice Address - Fax:510-433-0744
Is Sole Proprietor?:No
Enumeration Date:2007-06-08
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA200383163W00000X
CA1314364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARN200383OtherCLINICAL NURSE SPECIALIST