Healthcare Provider Details

I. General information

NPI: 1770823866
Provider Name (Legal Business Name): EMILY JOHANNAH PETERS-LIMBECK NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2013
Last Update Date: 02/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 N JACKSON AVE
SAN JOSE CA
95116-1903
US

IV. Provider business mailing address

1080 FOLSOM ST
SAN FRANCISCO CA
94103-4022
US

V. Phone/Fax

Practice location:
  • Phone: 917-327-8836
  • Fax:
Mailing address:
  • Phone: 917-327-8836
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number825339
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: