Healthcare Provider Details

I. General information

NPI: 1639590037
Provider Name (Legal Business Name): SARAH MCCALL PROCTOR NP, NMW, CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/02/2014
Last Update Date: 01/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1610 JUDAH ST
SAN FRANCISCO CA
94122-1720
US

IV. Provider business mailing address

1610 JUDAH ST
SAN FRANCISCO CA
94122-1720
US

V. Phone/Fax

Practice location:
  • Phone: 415-272-5832
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number638249
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number21478
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License Number3700
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number1986
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: