LAURENSIA HERMY WIDYASTAMI

SAN FRANCISCO, CA
NPI1427568351
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363L00000X Nurse Practitioner
(Licence: CA  95007344)
Enumeration Date2017-10-05
Last Update Date2017-10-05
Business Address
LAURENSIA HERMY WIDYASTAMI AGNP-BC
450 STANYAN ST
SAN FRANCISCO, CA 94117-1019
Phone number: 415-680-4135
Mailing Address
LAURENSIA HERMY WIDYASTAMI AGNP-BC
61A SUSSEX ST
SAN FRANCISCO, CA 94131-3011
Phone number: 626-232-1421
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