Healthcare Provider Details

I. General information

NPI: 1457907347
Provider Name (Legal Business Name): ARIANA JOSEFINA ANDERE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2019
Last Update Date: 04/29/2024
Certification Date: 04/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 PARNASSUS AVE BOX 0114
SAN FRANCISCO CA
94143-2204
US

IV. Provider business mailing address

505 PARNASSUS BOX 0114
SAN FRANCISCO CA
94143-2204
US

V. Phone/Fax

Practice location:
  • Phone: 415-353-2273
  • Fax: 415-353-2898
Mailing address:
  • Phone: 415-353-2273
  • Fax: 415-353-2898

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: