Healthcare Provider Details

I. General information

NPI: 1164479937
Provider Name (Legal Business Name): BETTY ANNE WEXLER RN CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3801 MIRANDA AVE MAIL CODE 182B/GRECC
PALO ALTO CA
94304-1207
US

IV. Provider business mailing address

3801 MIRANDA AVE MAIL CODE 182B/GRECC
PALO ALTO CA
94304-1207
US

V. Phone/Fax

Practice location:
  • Phone: 650-493-5000
  • Fax: 650-496-2505
Mailing address:
  • Phone: 650-493-5000
  • Fax: 650-496-2505

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SG0600X
TaxonomyGerontology Clinical Nurse Specialist
License Number385106
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: