1417224197 NPI number — MS. SHERRY REYNOLDS ALBRINK M.D.

Table of content: MS. SHERRY REYNOLDS ALBRINK M.D. (NPI 1417224197)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1417224197 NPI number — MS. SHERRY REYNOLDS ALBRINK M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ALBRINK
Provider First Name:
SHERRY
Provider Middle Name:
REYNOLDS
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
REYNOLDS
Provider Other First Name:
SHERRY
Provider Other Middle Name:
ELLEN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1417224197
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/24/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1442A WALNUT ST # 276
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BERKELEY
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94709
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
510-318-0030
Provider Business Mailing Address Fax Number:
510-981-1988

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3291 WALNUT BLVD
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
BRENTWOOD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94513
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
925-513-9495
Provider Business Practice Location Address Fax Number:
925-626-3782
Provider Enumeration Date:
11/22/2011

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  G85907 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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