Provider Demographics
NPI:1124298898
Name:GIRTON, JERYL ANN (MSN, FNP-BC,PMHNP-BC)
Entity type:Individual
Prefix:MS
First Name:JERYL
Middle Name:ANN
Last Name:GIRTON
Suffix:
Gender:F
Credentials:MSN, FNP-BC,PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:866 SANTA CRUZ DR
Mailing Address - Street 2:
Mailing Address - City:PLEASANT HILL
Mailing Address - State:CA
Mailing Address - Zip Code:94523
Mailing Address - Country:US
Mailing Address - Phone:925-676-6905
Mailing Address - Fax:415-296-5299
Practice Address - Street 1:2970 CAMINO DIABLO
Practice Address - Street 2:SUITE 300
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94597-9459
Practice Address - Country:US
Practice Address - Phone:925-360-5264
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-09
Last Update Date:2020-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA532089163WP0808X
CA17754363LF0000X, 363LP0808X
AZ219807363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily