Healthcare Provider Details

I. General information

NPI: 1497198162
Provider Name (Legal Business Name): SHEYNA ELIZABETH GIFFORD MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2013
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 HAWTHORNE AVE RM 5244
OAKLAND CA
94609-3108
US

IV. Provider business mailing address

350 HAWTHORNE AVE RM 5244
OAKLAND CA
94609-3108
US

V. Phone/Fax

Practice location:
  • Phone: 510-655-4000
  • Fax:
Mailing address:
  • Phone: 507-284-2511
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number2017020630
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code2083P0500X
TaxonomyPreventive Medicine/Occupational Environmental Medicine Physician
License Number77822
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: