Healthcare Provider Details

I. General information

NPI: 1972459337
Provider Name (Legal Business Name): ABIGAIL SEARS RANKIN FITZGERALD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ABI FITZGERALD

II. Dates (important events)

Enumeration Date: 03/09/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

436 MILLER CREEK RD
SAN RAFAEL CA
94903-1318
US

IV. Provider business mailing address

436 MILLER CREEK RD
SAN RAFAEL CA
94903-1318
US

V. Phone/Fax

Practice location:
  • Phone: 415-717-4664
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number801465
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: