Healthcare Provider Details

I. General information

NPI: 1629385794
Provider Name (Legal Business Name): LEAH DANIELLE WARNER FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2010
Last Update Date: 04/24/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1748 MARKET ST
SAN FRANCISCO CA
94102-5800
US

IV. Provider business mailing address

1748 MARKET ST
SAN FRANCISCO CA
94102-5800
US

V. Phone/Fax

Practice location:
  • Phone: 415-565-7667
  • Fax: 415-252-7512
Mailing address:
  • Phone: 415-565-7667
  • Fax: 415-252-7512

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number20242
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: