Healthcare Provider Details

I. General information

NPI: 1497081970
Provider Name (Legal Business Name): SHERRY LYNN GAULDIN CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2009
Last Update Date: 01/08/2024
Certification Date: 01/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 EMBARCADERO CTR LOBBY LEVEL
SAN FRANCISCO CA
94111-3823
US

IV. Provider business mailing address

2 EMBARCADERO CTR LOBBY LEVEL
SAN FRANCISCO CA
94111-3823
US

V. Phone/Fax

Practice location:
  • Phone: 415-578-3100
  • Fax: 415-291-0489
Mailing address:
  • Phone: 415-578-3100
  • Fax: 415-291-0489

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP004901B
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN2295919
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number084358-21
License Number StateNH
# 4
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95001910
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: