Healthcare Provider Details

I. General information

NPI: 1417863309
Provider Name (Legal Business Name): MYLA BERNAL TUASON LVN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

757 47TH AVE
SAN FRANCISCO CA
94121-3205
US

IV. Provider business mailing address

757 47TH AVE
SAN FRANCISCO CA
94121-3205
US

V. Phone/Fax

Practice location:
  • Phone: 415-221-4810
  • Fax: 415-379-5590
Mailing address:
  • Phone: 415-221-4810
  • Fax: 415-379-5590

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number209762
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: