Healthcare Provider Details

I. General information

NPI: 1639235112
Provider Name (Legal Business Name): SALLY VRANA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2154 BRODERICK ST
SAN FRANCISCO CA
94115-1628
US

IV. Provider business mailing address

2154 BRODERICK ST
SAN FRANCISCO CA
94115-1628
US

V. Phone/Fax

Practice location:
  • Phone: 415-673-4302
  • Fax:
Mailing address:
  • Phone: 415-673-4302
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberG62611
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: