Healthcare Provider Details

I. General information

NPI: 1194873844
Provider Name (Legal Business Name): JAMES D. ESKRIDGE NP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 09/23/2022
Certification Date: 03/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 2ND ST STE 104
SAN RAFAEL CA
94901-2701
US

IV. Provider business mailing address

CENTER POINT INC 1601 2ND ST. STE#108
SAN RAFAEL CA
94949
US

V. Phone/Fax

Practice location:
  • Phone: 415-456-6655
  • Fax: 415-456-0331
Mailing address:
  • Phone: 415-456-6655
  • Fax: 415-456-0331

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberRN328302
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberNPF5577
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: