Healthcare Provider Details

I. General information

NPI: 1861117863
Provider Name (Legal Business Name): SARAH MICHELLE BALL WHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/11/2022
Last Update Date: 01/17/2023
Certification Date: 01/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2970 HILLTOP MALL RD STE 307
RICHMOND CA
94806-5204
US

IV. Provider business mailing address

16 CAMELOT CT
KENSINGTON CA
94707-1306
US

V. Phone/Fax

Practice location:
  • Phone: 510-222-5290
  • Fax: 510-222-9231
Mailing address:
  • Phone: 510-220-3280
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number26NR22658500
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95300031
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN739994
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberL1-0067711
License Number StateDE
# 5
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number95023310
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: