Healthcare Provider Details

I. General information

NPI: 1144346230
Provider Name (Legal Business Name): GLORIA YVONNE SLOAN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/21/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 ADELINE ST
OAKLAND CA
94607-2608
US

IV. Provider business mailing address

3317 BRENTWOOD AVE
EL SOBRANTE CA
94803-2512
US

V. Phone/Fax

Practice location:
  • Phone: 510-835-9610
  • Fax: 510-893-4333
Mailing address:
  • Phone: 510-991-7415
  • Fax: 510-991-7415

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number9819
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: