Provider Demographics
NPI:1083400873
Name:SEWAK, PRISCILLA PRITTI (RN, BSN)
Entity type:Individual
Prefix:MISS
First Name:PRISCILLA
Middle Name:PRITTI
Last Name:SEWAK
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5407 HOMEWOOD WAY
Mailing Address - Street 2:
Mailing Address - City:RIVERBANK
Mailing Address - State:CA
Mailing Address - Zip Code:95367-9518
Mailing Address - Country:US
Mailing Address - Phone:209-985-8506
Mailing Address - Fax:
Practice Address - Street 1:1411 E 31ST ST # K-6
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94602-1092
Practice Address - Country:US
Practice Address - Phone:510-437-6478
Practice Address - Fax:510-436-5173
Is Sole Proprietor?:No
Enumeration Date:2025-04-17
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95314734163WX0003X, 163WW0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory
No163WX0003XNursing Service ProvidersRegistered NurseObstetric, Inpatient