Healthcare Provider Details

I. General information

NPI: 1942827464
Provider Name (Legal Business Name): AMY W SPARROW L.AC., DIPL.O.M.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/30/2020
Last Update Date: 07/10/2020
Certification Date: 07/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

557 WALLER ST
SAN FRANCISCO CA
94117-3330
US

IV. Provider business mailing address

888 HAIGHT ST
SAN FRANCISCO CA
94117-3217
US

V. Phone/Fax

Practice location:
  • Phone: 415-350-2458
  • Fax:
Mailing address:
  • Phone: 415-431-9793
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License NumberCA18238
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberCA18238
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: