Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | 1692 | CA |
NPI | 1023179983 |
---|---|
Provider Name | Sarah Bourguignon |
First Address | San Francisco, CA 94115-6107 |
Second Address | Walnut Creek, CA 94596-5318 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/12/2006 |
Last Update Date | 03/01/2022 |