Healthcare Provider Details

I. General information

NPI: 1497546972
Provider Name (Legal Business Name): JOEL ELLIOTT PARKER MSN, RN, PHN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2025
Last Update Date: 05/14/2025
Certification Date: 05/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 STEVENSON ST
SAN FRANCISCO CA
94103-1606
US

IV. Provider business mailing address

555 STEVENSON ST
SAN FRANCISCO CA
94103-1606
US

V. Phone/Fax

Practice location:
  • Phone: 415-310-5463
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WA2000X
TaxonomyAdministrator Registered Nurse
License Number95062439
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163WA2000X
TaxonomyAdministrator Registered Nurse
License Number95052439
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: