Healthcare Provider Details

I. General information

NPI: 1508308651
Provider Name (Legal Business Name): ERICA ROSE GAGLIARDI RN, MSN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/07/2016
Last Update Date: 01/11/2024
Certification Date: 01/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1545 DIVISADERO ST FL 2
SAN FRANCISCO CA
94143-3400
US

IV. Provider business mailing address

3451 E 12TH ST
OAKLAND CA
94601-3463
US

V. Phone/Fax

Practice location:
  • Phone: 415-353-7900
  • Fax: 415-353-2640
Mailing address:
  • Phone: 510-535-3319
  • Fax: 510-535-4187

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP95005277
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: