Healthcare Provider Details

I. General information

NPI: 1912202987
Provider Name (Legal Business Name): STEPHANIE MESSINA PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/21/2011
Last Update Date: 03/30/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2340 CLAY ST FL 6
SAN FRANCISCO CA
94115-1932
US

IV. Provider business mailing address

2340 CLAY ST FL 6
SAN FRANCISCO CA
94115-1932
US

V. Phone/Fax

Practice location:
  • Phone: 424-444-7399
  • Fax: 424-253-0814
Mailing address:
  • Phone: 424-444-7399
  • Fax: 424-253-0814

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA21409
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: