Provider Demographics
NPI:1154462323
Name:ROUILLARD, SHARON GERTZ (NP)
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:GERTZ
Last Name:ROUILLARD
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MS
Other - First Name:SHARON
Other - Middle Name:BETH
Other - Last Name:GERTZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP
Mailing Address - Street 1:5601 NORRIS CANYON RD
Mailing Address - Street 2:STE 140
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94583-5407
Mailing Address - Country:US
Mailing Address - Phone:925-830-0644
Mailing Address - Fax:925-830-0868
Practice Address - Street 1:5601 NORRIS CANYON RD
Practice Address - Street 2:STE 140
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-5407
Practice Address - Country:US
Practice Address - Phone:925-830-0644
Practice Address - Fax:925-830-0868
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA650324163W00000X
CA17101363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse