Provider Demographics
NPI:1376173476
Name:BRYDEN, SHARON SUZANNE (FNP)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:SUZANNE
Last Name:BRYDEN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:SUZANNE
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9746 TAREYTON AVE
Mailing Address - Street 2:
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94583-3146
Mailing Address - Country:US
Mailing Address - Phone:925-788-7131
Mailing Address - Fax:
Practice Address - Street 1:240 LA CASA VIA STE 200
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-4866
Practice Address - Country:US
Practice Address - Phone:925-945-6644
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-17
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95012882363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily