Provider Demographics
NPI:1700060019
Name:SLEETH, ALICE KAY (NP)
Entity Type:Individual
Prefix:
First Name:ALICE
Middle Name:KAY
Last Name:SLEETH
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:ALICE
Other - Middle Name:KAY
Other - Last Name:ERICKSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:2350 W EL CAMINO REAL
Mailing Address - Street 2:FL 2
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94040-6203
Mailing Address - Country:US
Mailing Address - Phone:707-541-7800
Mailing Address - Fax:707-578-5428
Practice Address - Street 1:3883 AIRWAY DR
Practice Address - Street 2:SUITE 120
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95403-1670
Practice Address - Country:US
Practice Address - Phone:707-521-8966
Practice Address - Fax:707-521-1301
Is Sole Proprietor?:No
Enumeration Date:2007-12-21
Last Update Date:2018-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11820363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner