Basic Information
Provider Information
NPI: 1760630941
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KRAY
FirstName: MARGARET
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: R.N., F.N.P.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2500 ALHAMBRA AVE
Address2:  
City: MARTINEZ
State: CA
PostalCode: 945533156
CountryCode: US
TelephoneNumber: 9253705110
FaxNumber: 9253705142
Practice Location
Address1: 1501 FRED JACKSON WAY
Address2:  
City: RICHMOND
State: CA
PostalCode: 948011516
CountryCode: US
TelephoneNumber: 9253705110
FaxNumber: 9253705142
Other Information
ProviderEnumerationDate: 08/31/2008
LastUpdateDate: 10/22/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
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AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000X683045CAN Nursing Service ProvidersRegistered Nurse 
363LF0000X18368CAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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