Provider Demographics
NPI:1255038592
Name:SAGE WOMEN'S HEALTH, A NURSING CORPORATION
Entity type:Organization
Organization Name:SAGE WOMEN'S HEALTH, A NURSING CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRITA
Authorized Official - Middle Name:
Authorized Official - Last Name:STONE
Authorized Official - Suffix:
Authorized Official - Credentials:CNM
Authorized Official - Phone:510-701-8056
Mailing Address - Street 1:1455 KRONBORG DR
Mailing Address - Street 2:
Mailing Address - City:SOLVANG
Mailing Address - State:CA
Mailing Address - Zip Code:93463-2028
Mailing Address - Country:US
Mailing Address - Phone:510-701-8056
Mailing Address - Fax:
Practice Address - Street 1:2029 VILLAGE LN STE 200
Practice Address - Street 2:
Practice Address - City:SOLVANG
Practice Address - State:CA
Practice Address - Zip Code:93463-2258
Practice Address - Country:US
Practice Address - Phone:805-500-8056
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-07
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1730362344Medicaid