Healthcare Provider Details

I. General information

NPI: 1841728334
Provider Name (Legal Business Name): DANNA FALLA RN, PHN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/26/2017
Last Update Date: 05/26/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

887 POTRERO AVE
SAN FRANCISCO CA
94110-2869
US

IV. Provider business mailing address

887 POTRERO AVE
SAN FRANCISCO CA
94110-2869
US

V. Phone/Fax

Practice location:
  • Phone: 415-206-2808
  • Fax:
Mailing address:
  • Phone: 415-206-2808
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number95034426
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: