Healthcare Provider Details

I. General information

NPI: 1326118704
Provider Name (Legal Business Name): MARIA AMADA F. APACIBLE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/09/2006
Last Update Date: 01/29/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 DIVISADERO
SAN FRANCISCO CA
94143-0001
US

IV. Provider business mailing address

160 DIVISADERO
SAN FRANCISCO CA
94143-0001
US

V. Phone/Fax

Practice location:
  • Phone: 415-567-6000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License Number562769
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: