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1427568351
LAURENSIA HERMY WIDYASTAMI
SAN FRANCISCO, CA
NPI
1427568351
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: CA 95007344)
Enumeration Date
2017-10-05
Last Update Date
2017-10-05
Business Address
LAURENSIA HERMY WIDYASTAMI AGNP-BC
450 STANYAN ST
SAN FRANCISCO, CA 94117-1019
Phone number: 415-680-4135
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Mailing Address
LAURENSIA HERMY WIDYASTAMI AGNP-BC
61A SUSSEX ST
SAN FRANCISCO, CA 94131-3011
Phone number: 626-232-1421
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