Healthcare Provider Details

I. General information

NPI: 1679466551
Provider Name (Legal Business Name): MISS TY STOKES STERLING
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/30/2025
Last Update Date: 06/25/2025
Certification Date: 06/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1735 MISSION ST
SAN FRANCISCO CA
94103-2417
US

IV. Provider business mailing address

564 MERRIMAC ST
OAKLAND CA
94612-1792
US

V. Phone/Fax

Practice location:
  • Phone: 415-565-7667
  • Fax: 415-252-7512
Mailing address:
  • Phone: 949-444-4942
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number10021
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: