Provider Demographics
NPI:1013420868
Name:MINAHAN, SARA EMILY NEFF (CNM, WHNP, RN)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:EMILY NEFF
Last Name:MINAHAN
Suffix:
Gender:F
Credentials:CNM, WHNP, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HIGHLAND HOSPITAL, DEPT OF MATERNAL-CHILD HEALTH
Mailing Address - Street 2:1411 E 31ST ST
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94602-1018
Mailing Address - Country:US
Mailing Address - Phone:510-437-4800
Mailing Address - Fax:
Practice Address - Street 1:1411 E 31ST ST
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94602-1018
Practice Address - Country:US
Practice Address - Phone:510-437-4800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-14
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA235916367A00000X
CA95007902363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA235916OtherNMW LICENSE
CA95007902OtherWHNP LICENSE
CA95066396OtherRN LICENSE