Healthcare Provider Details

I. General information

NPI: 1326193756
Provider Name (Legal Business Name): COURTNEY MCSPADDEN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2007
Last Update Date: 02/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 WEBSTER STREET SUITE 506
SAN FRANCISCO CA
94115
US

IV. Provider business mailing address

2100 WEBSTER STREET SUITE 506
SAN FRANCISCO CA
94115
US

V. Phone/Fax

Practice location:
  • Phone: 415-923-3067
  • Fax: 415-346-5019
Mailing address:
  • Phone: 415-923-3067
  • Fax: 415-346-5019

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number665017
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number17123
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: