Provider Demographics
NPI:1891195806
Name:MEADOWS, JOURNEY (NP)
Entity Type:Individual
Prefix:MS
First Name:JOURNEY
Middle Name:
Last Name:MEADOWS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 PARNASSUS AVE
Mailing Address - Street 2:15 LONG
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94143
Mailing Address - Country:US
Mailing Address - Phone:415-502-4906
Mailing Address - Fax:415-514-8192
Practice Address - Street 1:3260 SACRAMENTO ST
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94702-2739
Practice Address - Country:US
Practice Address - Phone:510-601-6060
Practice Address - Fax:510-425-4595
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-27
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95001253363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner