Healthcare Provider Details

I. General information

NPI: 1841087004
Provider Name (Legal Business Name): VERA WOMEN'S WELLNESS, A NURSING PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2025
Last Update Date: 04/22/2025
Certification Date: 04/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3536 HEIMBUCHER WAY
SANTA ROSA CA
95404-2030
US

IV. Provider business mailing address

3536 HEIMBUCHER WAY
SANTA ROSA CA
95404-2030
US

V. Phone/Fax

Practice location:
  • Phone: 916-792-9308
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: LAUREN LOCKWOOD
Title or Position: CEO & PRESIDENT
Credential:
Phone: 916-792-9308