Healthcare Provider Details

I. General information

NPI: 1033489349
Provider Name (Legal Business Name): DEBRA L BARTLETT NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DEBRA BARTLETT NP

II. Dates (important events)

Enumeration Date: 01/03/2012
Last Update Date: 08/06/2023
Certification Date: 08/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 PARNASSUS AVE
SAN FRANCISCO CA
94143-2204
US

IV. Provider business mailing address

505 PARNASSUS AVE
SAN FRANCISCO CA
94143-2204
US

V. Phone/Fax

Practice location:
  • Phone: 415-353-8031
  • Fax: 415-353-1784
Mailing address:
  • Phone: 415-353-8031
  • Fax: 415-353-1784

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number20689
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LP0222X
TaxonomyCritical Care Pediatric Nurse Practitioner
License Number20689
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code364SP0200X
TaxonomyPediatric Clinical Nurse Specialist
License Number2946
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP20689
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: