Healthcare Provider Details

I. General information

NPI: 1861818247
Provider Name (Legal Business Name): AUDRIANA TODD NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AUDRIANA GOMEZ RN-BC

II. Dates (important events)

Enumeration Date: 03/10/2014
Last Update Date: 11/03/2022
Certification Date: 11/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 CALIFORNIA ST SUITE 103
SAN FRANCISCO CA
94115-2753
US

IV. Provider business mailing address

325 DISTEL CIR
LOS ALTOS CA
94022-1408
US

V. Phone/Fax

Practice location:
  • Phone: 415-600-3503
  • Fax: 415-600-1327
Mailing address:
  • Phone: 415-600-3503
  • Fax: 415-600-1327

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number817757
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95018814
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: