Healthcare Provider Details

I. General information

NPI: 1801915095
Provider Name (Legal Business Name): DIANE B VOGELEI ANP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 DIVISADERO ST # 1661
SAN FRANCISCO CA
94115-3010
US

IV. Provider business mailing address

130 DEL ORO LAGOON
NOVATO CA
94949-5332
US

V. Phone/Fax

Practice location:
  • Phone: 415-885-7665
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0106X
TaxonomyOccupational Health Nurse Practitioner
License NumberRN236617
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: