Healthcare Provider Details

I. General information

NPI: 1053704676
Provider Name (Legal Business Name): LINDA CHAFETZ RN, PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/06/2015
Last Update Date: 03/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 KORET WAY
SAN FRANCISCO CA
94143-0608
US

IV. Provider business mailing address

2 KORET WAY
SAN FRANCISCO CA
94143-0608
US

V. Phone/Fax

Practice location:
  • Phone: 415-476-2726
  • Fax: 415-476-6042
Mailing address:
  • Phone: 415-476-2726
  • Fax: 415-476-6042

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number189862
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: