Basic Information
| Provider Information | |||||||||
| NPI: | 1467813683 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SHERRATT | ||||||||
| FirstName: | ELISABETH | ||||||||
| MiddleName: | ANNE | ||||||||
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| Credential: | FNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1152 BISMARCK LN | ||||||||
| Address2: | |||||||||
| City: | ALAMEDA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945026962 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 1559280603 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 3100 SUMMIT ST | ||||||||
| Address2: | 2ND FLOOR, SUITE 2549 | ||||||||
| City: | OAKLAND | ||||||||
| State: | CA | ||||||||
| PostalCode: | 946093412 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5108698865 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/16/2016 | ||||||||
| LastUpdateDate: | 06/02/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/02/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 95029500 | CA | N | Nursing Service Providers | Registered Nurse | 163WL0100X | L-302627 | ZZ | N | Nursing Service Providers | Registered Nurse | Lactation Consultant | 363LF0000X | 95003800 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.