Provider Demographics
NPI:1508005992
Name:BUSHMAN, SARI A (ADULT NP)
Entity Type:Individual
Prefix:
First Name:SARI
Middle Name:A
Last Name:BUSHMAN
Suffix:
Gender:F
Credentials:ADULT NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:829 SCOTT ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94117-1615
Mailing Address - Country:US
Mailing Address - Phone:510-333-5329
Mailing Address - Fax:
Practice Address - Street 1:240 SHOTWELL ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-1323
Practice Address - Country:US
Practice Address - Phone:415-552-1013
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-10
Last Update Date:2009-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18314363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health