Healthcare Provider Details

I. General information

NPI: 1023009107
Provider Name (Legal Business Name): MARY ANN SARREAL GELERA NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/29/2005
Last Update Date: 03/23/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

516 WILLOW ST
ALAMEDA CA
94501-6132
US

IV. Provider business mailing address

2385 CARTER LN
CASTRO VALLEY CA
94546-5216
US

V. Phone/Fax

Practice location:
  • Phone: 510-714-8097
  • Fax: 510-667-3933
Mailing address:
  • Phone: 510-886-2693
  • Fax: 510-667-3933

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberNP11544
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: