Healthcare Provider Details

I. General information

NPI: 1366516247
Provider Name (Legal Business Name): MS. ADRIENNE PATRICE LOW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1333 BUSH ST
SAN FRANCISCO CA
94109-5611
US

IV. Provider business mailing address

1333 BUSH ST
SAN FRANCISCO CA
94109-5611
US

V. Phone/Fax

Practice location:
  • Phone: 415-337-2865
  • Fax: 415-337-2867
Mailing address:
  • Phone: 415-337-2865
  • Fax: 415-337-2867

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberRN377692
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: