Healthcare Provider Details

I. General information

NPI: 1760845440
Provider Name (Legal Business Name): CLARE TIMBIE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2016
Last Update Date: 08/07/2023
Certification Date: 08/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1825 4TH ST
SAN FRANCISCO CA
94143-2350
US

IV. Provider business mailing address

550 16TH STREET, 4TH FLOOR UCSF CHILD NEUROLOGY, BOX 0137
SAN FRANCISCO CA
94143
US

V. Phone/Fax

Practice location:
  • Phone: 415-353-7596
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0402X
TaxonomyNeurology with Special Qualifications in Child Neurology Physician
License Number152983
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2084E0001X
TaxonomyEpilepsy Physician
License NumberA152983
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: