MEDICARE: SANFRANSKINNY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	132700000X	Dietary Manager		CA

General Provider Information

NPI Number	:	1760881858
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SANFRANSKINNY

Provider Business Mailing Address
First Line	:	11100 SAN PABLO AVE
Second Line	:	104
City	:	EL CERRITO
State	:	CA
Zip	:	94530-2194
Country	:	US
Telephone Number	:	415-383-9903
Fax Number	:	415-383-9901

Provider Business Practice Location Address
First Line	:	11100 SAN PABLO AVE
Second Line	:	104
City	:	EL CERRITO
State	:	CA
Zip	:	94530-2194
Country	:	US
Telephone Number	:	415-383-9903
Fax Number	:	415-383-9901

Authorized Official
Title or Position	:	OWNER
Name	:	MORGAN CAMP
Credential	:	M.D.
Telephone Number	:	415-383-9903

Provider Enumeration Date	:	08/14/2014
Last Update Date	:	08/14/2014

Similar Medicare Providers

1821929662 — JUSTYNA KARETA
Practice Location Address:

11100 SAN PABLO AVE
EL CERRITO, CA
94530-2194

Practice Phone: 510-260-0871
Practice Fax:

1679500227 — MS. JENNIFER F HALLER LCSW
Practice Location Address:

11100 SAN PABLO AVE , SUITE 202
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1104936269 — DR. ALLEN WILLIAM CURRANO JR. D.C.
Practice Location Address:

11100 SAN PABLO AVE , SUITE 104
EL CERRITO, CA
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Practice Phone: 510-232-4333
Practice Fax: 510-232-1982

1346334711 — DR. SUSAN MARINEL GREENE PH.D.
Practice Location Address:

11100 SAN PABLO AVE , SUITE 216
EL CERRITO, CA
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Practice Phone: 510-233-8402
Practice Fax: 510-233-8402

1942363643 — MS. ROXANNE FEAGLER STALLINGS MFT
Practice Location Address:

11100 SAN PABLO AVE , SUITE 209
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Practice Fax: 510-234-8734

1790973022 — LA'QUESHA MONIQUE FONROSE LCSW
Practice Location Address:

11100 SAN PABLO AVE ST. 204
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94530-2194

Practice Phone: 510-691-0818
Practice Fax:

Directions to “SANFRANSKINNY ” Practice Location

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