Healthcare Provider Details

I. General information

NPI: 1760598361
Provider Name (Legal Business Name): DENISE VAN OSTAEYEN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/23/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4150 CLEMENT ST 111C
SAN FRANCISCO CA
94121-1545
US

IV. Provider business mailing address

2025 PINE ST #1
SAN FRANCISCO CA
94115-2868
US

V. Phone/Fax

Practice location:
  • Phone: 415-221-4810
  • Fax: 415-750-6950
Mailing address:
  • Phone: 415-771-3257
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number452340
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: