Individual
SARAH ELIZABETH WICKMAN EZELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
33456 ALVARADO NILES RD, UNION CITY, CA 94587-3110
(510) 675-0600
Mailing address
33456 ALVARADO NILES RD, UNION CITY, CA 94587-3110
(510) 675-0600
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
240909
TN
163W00000X
Registered Nurse
95431552
CA
363L00000X
Nurse Practitioner
Primary
95038207
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
32005
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q076990
—
TN
Enumeration date
06/23/2022
Last updated
04/28/2026
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