Healthcare Provider Details

I. General information

NPI: 1225228844
Provider Name (Legal Business Name): MILDRED LOUISE SNEAD R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/30/2007
Last Update Date: 07/30/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

575 MARKET ST
SAN FRANCISCO CA
94105-2854
US

IV. Provider business mailing address

3976 OAK HILL RD
OAKLAND CA
94605-4931
US

V. Phone/Fax

Practice location:
  • Phone: 415-904-9682
  • Fax:
Mailing address:
  • Phone: 510-635-8231
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number260789
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: