Provider Demographics
NPI:1053537878
Name:OBICHERE, VIVIAN (CNA, HHA)
Entity type:Individual
Prefix:
First Name:VIVIAN
Middle Name:
Last Name:OBICHERE
Suffix:
Gender:F
Credentials:CNA, HHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2818 MONTAIR PL
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94587-1680
Mailing Address - Country:US
Mailing Address - Phone:650-306-1100
Mailing Address - Fax:
Practice Address - Street 1:643 BAIR ISLAND RD STE 106
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94063-2755
Practice Address - Country:US
Practice Address - Phone:650-306-1100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA00110496374U00000X
CA00224736376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered374U00000XNursing Service Related ProvidersHome Health Aide
Not Answered376K00000XNursing Service Related ProvidersNurse's Aide