Basic Information
Provider Information
NPI: 1205227980
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: O'LEARY
FirstName: SARAH
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: RN, MSN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1801 VICENTE ST
Address2:  
City: SAN FRANCISCO
State: CA
PostalCode: 941162923
CountryCode: US
TelephoneNumber: 4156813211
FaxNumber:  
Practice Location
Address1: 1801 VICENTE ST
Address2:  
City: SAN FRANCISCO
State: CA
PostalCode: 941162923
CountryCode: US
TelephoneNumber: 4156813211
FaxNumber:  
Other Information
ProviderEnumerationDate: 02/17/2015
LastUpdateDate: 02/17/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000X844773CAY Nursing Service ProvidersRegistered Nurse 

No ID Information.


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