Healthcare Provider Details

I. General information

NPI: 1992114821
Provider Name (Legal Business Name): CYNTHIA SHARPE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2014
Last Update Date: 04/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2344 6TH ST
BERKELEY CA
94710-2412
US

IV. Provider business mailing address

273 PURDUE AVE
KENSINGTON CA
94708-1136
US

V. Phone/Fax

Practice location:
  • Phone: 510-524-8619
  • Fax:
Mailing address:
  • Phone: 510-524-8619
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95000825
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: