Provider Demographics
NPI:1568585883
Name:THRESHER, SALLY S (NP MSN)
Entity Type:Individual
Prefix:MS
First Name:SALLY
Middle Name:S
Last Name:THRESHER
Suffix:
Gender:F
Credentials:NP MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2727 MARIPOSA ST STE 100
Mailing Address - Street 2:RAPE TREATMENT CENTER
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-1400
Mailing Address - Country:US
Mailing Address - Phone:415-437-3000
Mailing Address - Fax:415-437-3050
Practice Address - Street 1:2727 MARIPOSA ST STE 100
Practice Address - Street 2:RAPE TREATMENT CENTER
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-1400
Practice Address - Country:US
Practice Address - Phone:415-437-3000
Practice Address - Fax:415-437-3050
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN286498163WP2201X
NVRN40750163WP2201X
CANP7641363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care
Not Answered363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
982504OtherSFGH INTERNAL USE ONLY-COMMERCIAL NUMBER
Q37224Medicare UPIN