Healthcare Provider Details

I. General information

NPI: 1417301581
Provider Name (Legal Business Name): SARAH CLUFF RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2016
Last Update Date: 10/31/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3075 ADELINE ST STE 280
BERKELEY CA
94703-2580
US

IV. Provider business mailing address

5417 BELGRAVE PL
OAKLAND CA
94618-1743
US

V. Phone/Fax

Practice location:
  • Phone: 510-486-3471
  • Fax: 510-553-2171
Mailing address:
  • Phone: 510-504-5083
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95038486
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code364SG0600X
TaxonomyGerontology Clinical Nurse Specialist
License NumberCNS4530
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: