Sullivan, Stephanie M.

Sullivan, Stephanie M. is an individual health care provider with primary practice located at 2001 Dwight Way Second Floor, Berkeley CA 94704-2608. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Obstetrics & Gynecology, which is considered as her primary health care specialty. Sullivan, Stephanie M. can be contacted via phone (510) 204-5770.

Contact Information

Primary practice address
2001 Dwight Way Second Floor Berkeley CA 94704-2608
Phone: (510) 204-5770
Fax: (510) 204-5749
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Obstetrics & Gynecology 363LX0001X 566514 California

Profile Details

NPI number 1730121864
LBN Legal business name Sullivan, Stephanie M.
Credentials MSN, NP
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 12th, 2006
Last updated Jan 11th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1730121864 NPPES
California MEDICAID 005665140

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