Basic Information
| Provider Information | |||||||||
| NPI: | 1154892149 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | COLEMAN | ||||||||
| FirstName: | SARA | ||||||||
| MiddleName: | ASHLEY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 213 QUARRY RD FL 4 | ||||||||
| Address2: | |||||||||
| City: | PALO ALTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 943041416 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6507236469 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 213 QUARRY RD FL 4 | ||||||||
| Address2: | |||||||||
| City: | PALO ALTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 943041416 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6507236469 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/17/2018 | ||||||||
| LastUpdateDate: | 08/20/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/20/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | NP95010356 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.