Healthcare Provider Details

I. General information

NPI: 1568010312
Provider Name (Legal Business Name): GIANVIEVE SCHWIRBLAT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2019
Last Update Date: 04/30/2024
Certification Date: 04/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

844 OLD TUNNEL RD
GRASS VALLEY CA
95945-8524
US

IV. Provider business mailing address

3257 PROFESSIONAL DR STE C
AUBURN CA
95602-2460
US

V. Phone/Fax

Practice location:
  • Phone: 530-274-9762
  • Fax: 530-273-7255
Mailing address:
  • Phone: 530-802-0601
  • Fax: 663-295-6678

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95013417
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95156548
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: