Healthcare Provider Details

I. General information

NPI: 1801130745
Provider Name (Legal Business Name): MS. LIZBETH DELGADILLO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/15/2012
Last Update Date: 04/14/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2919 MISSION ST
SAN FRANCISCO CA
94110-3917
US

IV. Provider business mailing address

2919 MISSION ST
SAN FRANCISCO CA
94110-3917
US

V. Phone/Fax

Practice location:
  • Phone: 415-229-0500
  • Fax:
Mailing address:
  • Phone: 415-229-0500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number63586
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: