Healthcare Provider Details

I. General information

NPI: 1245830223
Provider Name (Legal Business Name): ALEXY FRANCISCO ANDRADE RN, MSN, FNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/28/2020
Last Update Date: 11/16/2023
Certification Date: 11/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 SHOTWELL ST
SAN FRANCISCO CA
94110-1323
US

IV. Provider business mailing address

240 SHOTWELL ST
SAN FRANCISCO CA
94110-1323
US

V. Phone/Fax

Practice location:
  • Phone: 415-552-3870
  • Fax: 415-552-3446
Mailing address:
  • Phone: 415-552-3446
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95015700
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: