MS. STEPHANIE M. SULLIVAN


Address: 2001 Dwight Way, Second Floor, Berkeley, CA 94704-2608
Phone: 5102045770

MS. STEPHANIE M. SULLIVAN (NPI# 1730121864) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1730121864
Entity Type Individual
Full Name MS. STEPHANIE M. SULLIVAN
Other Name MS. STEPHANIE MAYER
Credential MSN, NP
Practice Address 2001 Dwight Way
Second Floor
Berkeley
CA 94704-2608
Practice Telephone 5102045770
Practice Fax Number 5102045749
Mailing Telephone 5102045770
Mailing Fax Number 5102045749
Enumeration Date 2006-06-12
Last Update Date 2015-05-12
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LX0001X Nurse Practitioner
Specialization: Obstetrics & Gynecology
566514 CA Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
CA 005665140 05

Other Providers STEPHANIE SULLIVAN

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Office Location

Street Address 2001 DWIGHT WAY
SECOND FLOOR
City BERKELEY
State CA
Zip Code 94704-2608

Providers in the same location

NPI Name Taxonomy Address Enumeration
1295738805 Bay Area Rehabilitation Medical Group Physical Medicine & Rehabilitation 2001 Dwight Way, Berkeley, CA 94704-2608 2005-05-27
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1013401983 Lindsey Olander Speech-Language Pathologist 2001 Dwight Way, Berkeley, CA 94704-2608 2018-06-14
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1336529106 Alta Bates Summit Medical Center Clinic/Center 2001 Dwight Way, Berkeley, CA 94704-2608 2015-06-05
1538563614 Sutter East Bay Hospitals Pharmacy 2001 Dwight Way, Suite 2182, Berkeley, CA 94704-2608 2014-10-17
1821405192 Altabates Comprehensive Cancer Center Clinic/Center 2001 Dwight Way, Berkeley, CA 94704-2608 2014-07-17
1942624408 Karri Kennedy Occupational Therapist 2001 Dwight Way, Berkeley, CA 94704-2608 2014-02-04
1740611375 Rebecca Hummel-moore Nurse Practitioner 2001 Dwight Way, Berkeley, CA 94704-2608 2013-12-08
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1821698887 Ka Yin Emma Liu Counselor 1936 University Avenue, Partnerships for Trauma Recover, Suite 191, Berkeley, CA 94704 2020-10-29
1821617168 Michelle Nagal Hunt Behavior Technician 2080 Addison Street, #302, Berkeley, CA 94704 2020-04-15
1366097081 Sabrina Barnett Behavior Technician 2080 Addison St, #302, Berkeley, CA 94704 2019-08-08
1811559735 Bonita House, Inc. Community/Behavioral Health 1909 University Ave, Berkeley, CA 94704 2019-07-01
1376014928 Justin T Cooke Specialist/Technologist 2024 Durant Ave #508, Berkeley, CA 94704 2018-12-07
1972080158 Cecilia Winfield Student in an Organized Health Care Education/Training Program 1918 University Ave., Suite 2b, Berkeley, CA 94704 2018-07-20
1952897332 Jennifer Henry Henry Naturopath 2041 Bancroft Way #303, 2041 Bancroft Way, Berkeley, CA 94704 2018-07-09
1497267967 Merlenet Michelle Riley Counselor 2640 Martin Luther King, Berkeley, CA 94704 2017-10-24
1265951719 Caitlin Mary Mcdonough Student in an Organized Health Care Education/Training Program 1918 University Avenue, Suite 2b, Berkeley, CA 94704 2017-09-15
1922525120 Patrice Werling Counselor 1918 University Avenue, Suite 2b, Berkeley, CA 94704 2017-08-28
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Taxonomy Information

Taxonomy Code 363LX0001X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Obstetrics & Gynecology

Taxonomy Definition

Definition to come...

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Competitor

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City BERKELEY
Zip Code 94704

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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