Healthcare Provider Details

I. General information

NPI: 1588015655
Provider Name (Legal Business Name): MS. ATALYA TANU HARRIS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2016
Last Update Date: 07/02/2024
Certification Date: 07/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1182 MARKET ST STE 300
SAN FRANCISCO CA
94102-4919
US

IV. Provider business mailing address

1182 MARKET ST STE 300
SAN FRANCISCO CA
94102-4919
US

V. Phone/Fax

Practice location:
  • Phone: 415-915-0505
  • Fax: 415-915-0909
Mailing address:
  • Phone: 415-915-0505
  • Fax: 415-915-0909

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: