Healthcare Provider Details

I. General information

NPI: 1447557525
Provider Name (Legal Business Name): SARAH L CHOW NP, MHS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/25/2011
Last Update Date: 01/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1165 MONTGOMERY DR
SANTA ROSA CA
95405-4801
US

IV. Provider business mailing address

1154 MONTGOMERY DR
SANTA ROSA CA
95405-4816
US

V. Phone/Fax

Practice location:
  • Phone: 707-547-4611
  • Fax:
Mailing address:
  • Phone: 707-293-3845
  • Fax: 707-303-8362

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number17091
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number640386
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: