Healthcare Provider Details

I. General information

NPI: 1922579994
Provider Name (Legal Business Name): RACHEL CATHLEEN DEO CAMPO FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/16/2018
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1545 DIVISADERO ST STE 100
SAN FRANCISCO CA
94143-3400
US

IV. Provider business mailing address

1545 DIVISADERO ST STE 100
SAN FRANCISCO CA
94143-3400
US

V. Phone/Fax

Practice location:
  • Phone: 415-353-7900
  • Fax: 415-353-7901
Mailing address:
  • Phone: 415-353-7900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95024453
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: