Healthcare Provider Details

I. General information

NPI: 1114388048
Provider Name (Legal Business Name): ERIKA KIEFER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2016
Last Update Date: 03/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 POTRERO AVE
SAN FRANCISCO CA
94110-3518
US

IV. Provider business mailing address

1062 54TH ST
EMERYVILLE CA
94608-3017
US

V. Phone/Fax

Practice location:
  • Phone: 415-206-8000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number663860
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: