| NPI | 1326170374 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE KEANEY Practice Manager 415-380-0480 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: CA C38406) |
| Additional Taxonomies | 2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: CA C39226) |
| 363LF0000X Nurse Practitioner, Family (Licence: CA 11549) | |
| 364S00000X Clinical Nurse Specialist (Licence: CA 370895) | |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2015-04-23 |