Provider Demographics
NPI:1821373044
Name:BARNES-PERRILLIAT, ANASTASIA DEBORAH (FNP)
Entity Type:Individual
Prefix:
First Name:ANASTASIA
Middle Name:DEBORAH
Last Name:BARNES-PERRILLIAT
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:229 7TH ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-4003
Mailing Address - Country:US
Mailing Address - Phone:415-503-6000
Mailing Address - Fax:415-503-6099
Practice Address - Street 1:2580 SAN PABLO AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94612-1160
Practice Address - Country:US
Practice Address - Phone:510-439-8937
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-19
Last Update Date:2015-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANPF14762363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily