Healthcare Provider Details

I. General information

NPI: 1205550159
Provider Name (Legal Business Name): NAMOSHRI JILL CHAUDHURI RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2022
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1663 MISSION ST STE 250
SAN FRANCISCO CA
94103-2488
US

IV. Provider business mailing address

368 FELL ST
SAN FRANCISCO CA
94102-5144
US

V. Phone/Fax

Practice location:
  • Phone: 415-386-6600
  • Fax: 415-751-3226
Mailing address:
  • Phone: 415-861-0828
  • Fax: 415-861-0140

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95031709
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95306250
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95031709
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number041.531354
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: