Healthcare Provider Details

I. General information

NPI: 1477217909
Provider Name (Legal Business Name): STEPHANIE RIGOR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/30/2021
Last Update Date: 10/30/2021
Certification Date: 10/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 PACIFIC AVE
SAN FRANCISCO CA
94111-2009
US

IV. Provider business mailing address

249 S CORONADO ST APT 7
LOS ANGELES CA
90057-1629
US

V. Phone/Fax

Practice location:
  • Phone: 415-200-2099
  • Fax:
Mailing address:
  • Phone: 908-875-1132
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95018672
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: