Healthcare Provider Details

I. General information

NPI: 1174432819
Provider Name (Legal Business Name): SYREETA CORBITT NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2026
Last Update Date: 09/07/2026
Certification Date: 09/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3860 BALFOUR RD STE B
BRENTWOOD CA
94513-1645
US

IV. Provider business mailing address

4000 PIMLICO DR STE 114-260
PLEASANTON CA
94588-3474
US

V. Phone/Fax

Practice location:
  • Phone: 510-691-2083
  • Fax:
Mailing address:
  • Phone: 510-691-2083
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number583136
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: