Healthcare Provider Details

I. General information

NPI: 1457483489
Provider Name (Legal Business Name): LAUREN E. POOLE NP MSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/13/2007
Last Update Date: 01/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

995 POTRERO AVE BLDG 80 POSITIVE HEALTH PROGRAM
SAN FRANCISCO CA
94110-2859
US

IV. Provider business mailing address

995 POTRERO AVE BLDG 80 POSITIVE HEALTH PROGRAM
SAN FRANCISCO CA
94110-2859
US

V. Phone/Fax

Practice location:
  • Phone: 415-476-9296
  • Fax: 415-476-6736
Mailing address:
  • Phone: 415-476-9296
  • Fax: 415-476-6736

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License NumberRN372415
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP756
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: