Active NPI
Sharya Vaughan Bourdet
- Pharmacist
- San Francisco, CA
National Provider Identifier
1093728396
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH 52102
- Practice address
- Pharmacy Service (119) Vamc
4150 Clement St
San Francisco, CA 94121-1545 - Phone
- (415) 221-4810
- NPI assigned
- Aug 15, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH 52102 | CA | Primary |
Addresses
Primary practice location
Pharmacy Service (119) Vamc
4150 Clement St
San Francisco, CA 94121-1545
Mailing address
614 Bayview Ave
Millbrae, CA 94030-1159
Phone (650) 952-3855
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH 52102 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155600000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1093728396",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "614 BAYVIEW AVE",
"city": "MILLBRAE",
"state": "CA",
"postal_code": "940301159",
"telephone_number": "650-952-3855"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "PHARMACY SERVICE (119) VAMC",
"address_2": "4150 CLEMENT ST",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941211545",
"telephone_number": "415-221-4810"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOURDET",
"first_name": "SHARYA",
"middle_name": "VAUGHAN",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "RPH 52102",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Francisco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.