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Provider Information for 1295846822

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know


Gender: FEMALE

Individual NPI: 1295846822

Calendar   Last Updated:  2008-03-11
  Certification Date: 


Name Value
NPI 1295846822
Enumeration Date 2006-08-31
NPI Type 1 - Individual
Sole Proprietor YES
Status Active
Mailing Address 1277 HOWARD ST # 2
SAN FRANCISCO, CA 94103-2711
United States

Phone: | Fax:
View Map External Link
Primary Practice Address 4501 SAND CREEK RD
ANTIOCH, CA 94531-8687
United States

Phone: 925-813-3840 | Fax: 925-813-3841
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Primary Taxonomy Selected Taxonomy State License Number
Yes 2084N0400X - Psychiatry & Neurology Neurology CA C52291