Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Andrea Banouvong

Individual provider Acute Care Nurse Practitioner · NPI 1073137634

Andrea Banouvong is a Nurse Practitioner in San Lorenzo, California. Graduated from University of California, San Francisco School of Medicine in 2019, 7 years ago. Practices with Sutter Bay Medical Foundation, a 3,762-clinician group, accepts Medicare assignment and offers telehealth. Licensed in California.

Years since qualifying
7
Trained at
University of California, San Francisco School of Medicine
Licensed in
CA
In the registry since
2020
Specialties on file
2

Practice location Address checks out

927 Via Honda
San Lorenzo, CA 94580-2815
Phone: (510) 407-0749
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 95013507 (CA)
Acute Care Nurse Practitioner Taxonomy 363LA2100X · Licence 95013507 (CA)

Record details

NPI number1073137634
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedMay 29, 2020
Last updated in NPPESMay 29, 2020
Certification dateMay 29, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolUNIVERSITY OF CALIFORNIA, SAN FRANCISCO SCHOOL OF MEDICINE
Graduated 2019 (7 years in practice)
Group practice Sutter Bay Medical Foundation — 3762 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare