Healthcare Provider Details

I. General information

NPI: 1801968037
Provider Name (Legal Business Name): KIMBERLY Y. LAU NURSE PRACTITIONER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2006
Last Update Date: 01/03/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2350 GEARY BLVD FL 2
SAN FRANCISCO CA
94115-3305
US

IV. Provider business mailing address

2350 GEARY BLVD FL 2
SAN FRANCISCO CA
94115-3305
US

V. Phone/Fax

Practice location:
  • Phone: 415-833-2616
  • Fax:
Mailing address:
  • Phone: 415-833-2616
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number10238
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: