Provider Demographics
NPI:1003092297
Name:CURRY-SPARKS, KATHLEEN GRANT (RN, CNM)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:GRANT
Last Name:CURRY-SPARKS
Suffix:
Gender:F
Credentials:RN, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1728 MARIN AVE
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94707-2206
Mailing Address - Country:US
Mailing Address - Phone:510-525-9342
Mailing Address - Fax:
Practice Address - Street 1:1866 B ST
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94541-3139
Practice Address - Country:US
Practice Address - Phone:510-733-1819
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-17
Last Update Date:2008-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1756367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife