Healthcare Provider Details

I. General information

NPI: 1285564807
Provider Name (Legal Business Name): NEENNARA HIRUNKUL RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2026
Last Update Date: 05/23/2026
Certification Date: 05/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 LLOYD ST
SAN FRANCISCO CA
94117-3218
US

IV. Provider business mailing address

45 LLOYD ST
SAN FRANCISCO CA
94117-3218
US

V. Phone/Fax

Practice location:
  • Phone: 415-728-7865
  • Fax:
Mailing address:
  • Phone: 415-728-7865
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number95455811
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: