Individual provider Active NPI

Sunny Elizabeth St. Germain, NP

  • Pediatric Nurse Practitioner
  • San Rafael, CA
National Provider Identifier
1073693362
Registry record updated May 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
NP15105 Issued in CA
Practice address
3260 Kerner Blvd
San Rafael, CA 94901-4840
Phone
(415) 448-1536
Fax
(415) 461-7334
NPI assigned
Oct 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 201810581NP-PP OR
Pediatric Nurse Practitioner 363LP0200X NP15105 CA Primary

Addresses

Primary practice location

3260 Kerner Blvd
San Rafael, CA 94901-4840

Mailing address

8645 SE Sunnybrook Blvd Ste 200
Clackamas, OR 97015-6841
Phone (503) 659-1694

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220208002109 CA Order and Referring Only - Nurse Practitioner 7416340856

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP15105CAMDPediatric Nurse Practitioner
201810581NP-PPORMDPediatric Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: sstgermain585310@direct.ochin.org

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778025600000",
    "number": "1073693362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8645 SE SUNNYBROOK BLVD STE 200",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970156841",
            "telephone_number": "503-659-1694",
            "fax_number": "503-659-8984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3260 KERNER BLVD",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949014840",
            "telephone_number": "415-448-1536",
            "fax_number": "415-461-7334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ST. GERMAIN",
        "first_name": "SUNNY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2026-05-06",
        "certification_date": "2026-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "OR",
            "license": "201810581NP-PP",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CA",
            "license": "NP15105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Rafael, CA

Sources for this page

Verify at the official NPI Registry.