Healthcare Provider Details

I. General information

NPI: 1831032952
Provider Name (Legal Business Name): STEPHANIE BRIZUELA HERRERA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2026
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2919 MISSION ST
SAN FRANCISCO CA
94110-3917
US

IV. Provider business mailing address

2919 MISSION ST
SAN FRANCISCO CA
94110-3917
US

V. Phone/Fax

Practice location:
  • Phone: 415-229-0500
  • Fax: 415-647-3662
Mailing address:
  • Phone: 415-229-0500
  • Fax: 415-647-3662

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247200000X
TaxonomyOther Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: