Healthcare Provider Details

I. General information

NPI: 1437299765
Provider Name (Legal Business Name): SHARON LEE BARTELS RN,FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/07/2007
Last Update Date: 05/04/2023
Certification Date: 05/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 W HILLSDALE BLVD
SAN MATEO CA
94402-3757
US

IV. Provider business mailing address

3401 CSM DR
SAN MATEO CA
94402-3651
US

V. Phone/Fax

Practice location:
  • Phone: 650-574-6396
  • Fax:
Mailing address:
  • Phone: 650-357-4639
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC1400X
TaxonomyCollege Health Registered Nurse
License Number209483
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number14521F
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: