Healthcare Provider Details

I. General information

NPI: 1164853073
Provider Name (Legal Business Name): PSYCHE LINNEA PHILIPS NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/02/2013
Last Update Date: 12/17/2020
Certification Date: 12/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1748 MARKET ST SUITE 201
SAN FRANCISCO CA
94102-5800
US

IV. Provider business mailing address

1748 MARKET ST SUITE 201
SAN FRANCISCO CA
94102-5800
US

V. Phone/Fax

Practice location:
  • Phone: 415-565-7667
  • Fax:
Mailing address:
  • Phone: 415-565-7667
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number23765
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: