Healthcare Provider Details

I. General information

NPI: 1053594200
Provider Name (Legal Business Name): CHERYL JAN UBERMAN RN,MSN,CNS,APRN-BC,
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/11/2007
Last Update Date: 04/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 QUARRY CT APT 208
POINT RICHMOND CA
94801-4154
US

IV. Provider business mailing address

1301 QUARRY CT APT 208
POINT RICHMOND CA
94801-4154
US

V. Phone/Fax

Practice location:
  • Phone: 510-235-2069
  • Fax: 415-289-1130
Mailing address:
  • Phone: 510-235-2069
  • Fax: 415-289-1130

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberNP 17421
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: