Healthcare Provider Details

I. General information

NPI: 1275716623
Provider Name (Legal Business Name): BEVERLY SWEENEY MSN RN-BC PHN CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/07/2007
Last Update Date: 12/23/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 PIERCE ST
SAN FRANCISCO CA
94115-4005
US

IV. Provider business mailing address

1301 PIERCE ST
SAN FRANCISCO CA
94115-4005
US

V. Phone/Fax

Practice location:
  • Phone: 415-292-1344
  • Fax: 415-292-1344
Mailing address:
  • Phone: 415-292-1344
  • Fax: 415-292-1344

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number615478
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: