Healthcare Provider Details

I. General information

NPI: 1346156924
Provider Name (Legal Business Name): ELIZABETH LOUISE THURSTONE AGNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/21/2026
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

355 N WOLFE RD APT 424
SUNNYVALE CA
94085-3856
US

IV. Provider business mailing address

355 N WOLFE RD APT 424
SUNNYVALE CA
94085-3856
US

V. Phone/Fax

Practice location:
  • Phone: 650-678-5148
  • Fax:
Mailing address:
  • Phone: 650-678-5148
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number95041050
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number95041050
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: