Healthcare Provider Details

I. General information

NPI: 1598919417
Provider Name (Legal Business Name): ANN W MITCHELL NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/05/2008
Last Update Date: 04/19/2021
Certification Date: 04/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 SHATTUCK AVE STE A
BERKELEY CA
94709-1872
US

IV. Provider business mailing address

1 EMBARCADERO CTR STE 1900
SAN FRANCISCO CA
94111-3723
US

V. Phone/Fax

Practice location:
  • Phone: 510-225-1025
  • Fax: 510-225-1019
Mailing address:
  • Phone: 415-658-6791
  • Fax: 415-520-0904

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number19626
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: