Basic Information
Provider Information
NPI: 1407183858
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SYTOVA
FirstName: OKSANA
MiddleName:  
NamePrefix: MRS.
NameSuffix:  
Credential: N.P.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 130 SUTTER ST FL 2
Address2:  
City: SAN FRANCISCO
State: CA
PostalCode: 941044009
CountryCode: US
TelephoneNumber: 4156586791
FaxNumber: 4155200904
Practice Location
Address1: 350 BON AIR CTR
Address2: SUITE 200
City: GREENBRAE
State: CA
PostalCode: 949043000
CountryCode: US
TelephoneNumber: 4155783095
FaxNumber: 4152910489
Other Information
ProviderEnumerationDate: 11/05/2009
LastUpdateDate: 01/12/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000X19067CAY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


Home