Healthcare Provider Details

I. General information

NPI: 1558103887
Provider Name (Legal Business Name): ERIN CAMPBELLL
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2024
Last Update Date: 06/07/2024
Certification Date: 06/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 POTRERO AVE # 7M
SAN FRANCISCO CA
94110-3518
US

IV. Provider business mailing address

1270 7TH AVE APT 5
SAN FRANCISCO CA
94122-2549
US

V. Phone/Fax

Practice location:
  • Phone: 628-206-8426
  • Fax:
Mailing address:
  • Phone: 323-313-9602
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: