Healthcare Provider Details

I. General information

NPI: 1770828014
Provider Name (Legal Business Name): CRISTINA A AZZOLA N.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/27/2012
Last Update Date: 12/06/2022
Certification Date: 12/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2460 MISSION ST STE 212
SAN FRANCISCO CA
94110-2458
US

IV. Provider business mailing address

584 CASTRO ST # 633
SAN FRANCISCO CA
94114-2512
US

V. Phone/Fax

Practice location:
  • Phone: 415-990-7286
  • Fax:
Mailing address:
  • Phone: 415-990-7286
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License NumberND-538
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: