Healthcare Provider Details

I. General information

NPI: 1760326862
Provider Name (Legal Business Name): JACQUELINE HURST RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2026
Last Update Date: 04/17/2026
Certification Date: 04/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3490 CALIFORNIA ST
SAN FRANCISCO CA
94118-1891
US

IV. Provider business mailing address

1 HAWTHORNE ST UNIT 4A
SAN FRANCISCO CA
94105-3976
US

V. Phone/Fax

Practice location:
  • Phone: 415-514-7439
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number801463
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: