Healthcare Provider Details

I. General information

NPI: 1962529339
Provider Name (Legal Business Name): ALICE L. CHAN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 POTRERO AVE # 6M5 SFGH CHILDREN'S HEALTH CENTER
SAN FRANCISCO CA
94110-3518
US

IV. Provider business mailing address

1001 POTRERO AVE # 6M5 SFGH CHILDREN'S HEALTH CENTER
SAN FRANCISCO CA
94110-3518
US

V. Phone/Fax

Practice location:
  • Phone: 415-206-3609
  • Fax: 415-206-6900
Mailing address:
  • Phone: 415-206-3609
  • Fax: 415-206-6900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License NumberRN283520
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberNPF3498
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: