Healthcare Provider Details

I. General information

NPI: 1194983627
Provider Name (Legal Business Name): REBECCA HESS AMIRAULT CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2008
Last Update Date: 02/11/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1580 VALENCIA ST SUITE 508
SAN FRANCISCO CA
94110-4423
US

IV. Provider business mailing address

3555 CESAR CHAVEZ SUITE 112
SAN FRANCISCO CA
94110-4403
US

V. Phone/Fax

Practice location:
  • Phone: 415-641-6996
  • Fax: 415-641-6899
Mailing address:
  • Phone: 415-641-6452
  • Fax: 415-641-6899

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberNMW1772
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: