Healthcare Provider Details

I. General information

NPI: 1356204457
Provider Name (Legal Business Name): RAYSHIKA RENEE OVERSTREET LVN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/05/2025
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

822 GEARY ST
SAN FRANCISCO CA
94109-7228
US

IV. Provider business mailing address

125 SURF WAY APT 444
MONTEREY CA
93940-3425
US

V. Phone/Fax

Practice location:
  • Phone: 628-216-0303
  • Fax:
Mailing address:
  • Phone: 504-265-2079
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number726737
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: