Healthcare Provider Details

I. General information

NPI: 1942916275
Provider Name (Legal Business Name): SHARLA BAKER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/30/2023
Last Update Date: 01/30/2023
Certification Date: 01/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 BON AIR RD
GREENBRAE CA
94904-1702
US

IV. Provider business mailing address

78 RIDGE RD
FAIRFAX CA
94930-1921
US

V. Phone/Fax

Practice location:
  • Phone: 415-755-5298
  • Fax:
Mailing address:
  • Phone: 415-755-5298
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number489691
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: