Healthcare Provider Details

I. General information

NPI: 1558559583
Provider Name (Legal Business Name): STEFAN L STRASSFELD RN, PHN, CNS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2007
Last Update Date: 06/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 VAN NESS AVE #210 - MCAH
SAN FRANCISCO CA
94102-6020
US

IV. Provider business mailing address

30 VAN NESS AVE #210 - MCAH
SAN FRANCISCO CA
94102-6020
US

V. Phone/Fax

Practice location:
  • Phone: 800-300-9950
  • Fax: 415-581-2327
Mailing address:
  • Phone: 800-300-9950
  • Fax: 415-581-2327

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number641860
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: