Healthcare Provider Details

I. General information

NPI: 1912358292
Provider Name (Legal Business Name): CHINYERE EBOCHIE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2016
Last Update Date: 06/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 PIERCE ST
SAN FRANCISCO CA
94115
US

IV. Provider business mailing address

1301 PIERCE ST
SAN FRANCISCO CA
94115-4005
US

V. Phone/Fax

Practice location:
  • Phone: 415-563-8200
  • Fax:
Mailing address:
  • Phone: 415-563-8200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License NumberVN 211193
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: