Healthcare Provider Details

I. General information

NPI: 1174486377
Provider Name (Legal Business Name): ELIZABETH PAPP-VANCELLETTE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ELIZABETH PAPP

II. Dates (important events)

Enumeration Date: 12/04/2025
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1975 4TH ST
SAN FRANCISCO CA
94143-2351
US

IV. Provider business mailing address

2434 32ND AVE
SAN FRANCISCO CA
94116-2237
US

V. Phone/Fax

Practice location:
  • Phone: 415-353-8847
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WN0002X
TaxonomyNeonatal Intensive Care Registered Nurse
License Number720766
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number22287
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License Number4746
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: