Basic Information
Provider Information
NPI: 1437498607
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ASHIKU
FirstName: MAUREEN
MiddleName: ALICE
NamePrefix: MRS.
NameSuffix:  
Credential: NP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1 EMBARCADERO CTR STE 1900
Address2:  
City: SAN FRANCISCO
State: CA
PostalCode: 941113723
CountryCode: US
TelephoneNumber: 4156586791
FaxNumber:  
Practice Location
Address1: 3850 GRAND AVE
Address2:  
City: OAKLAND
State: CA
PostalCode: 946101004
CountryCode: US
TelephoneNumber: 5102251013
FaxNumber:  
Other Information
ProviderEnumerationDate: 02/07/2013
LastUpdateDate: 12/29/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 12/29/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000X790508CAN Nursing Service ProvidersRegistered Nurse 
363LF0000X790508CAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


Home