Healthcare Provider Details

I. General information

NPI: 1780881045
Provider Name (Legal Business Name): KAREN CHRISTINE BAGATELOS M.S.N.,N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 PARNASSUS AVE SUITE 410
SAN FRANCISCO CA
94117-3608
US

IV. Provider business mailing address

732 CHENERY ST
SAN FRANCISCO CA
94131-2907
US

V. Phone/Fax

Practice location:
  • Phone: 415-502-2211
  • Fax: 415-514-3300
Mailing address:
  • Phone: 415-502-2112
  • Fax: 415-514-3300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number461826
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: