Individual provider · Type 1 NPI

Albert Vincent Lebouton Iv, SRNA

Student in an Organized Health Care Education/Training Program · Oakland, CA

NPI number 1780319608 Active

Practice location

3100 Telegraph Ave Ste 350
Oakland, CA 94609-3239

Call (800) 607-6377 Map

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1780319608

Albert Vincent Lebouton Iv, SRNA's National Provider Identifier is 1780319608, issued on Jul 24, 2022. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Oakland, CA. The record was last updated on Jul 24, 2022.