Healthcare Provider Details

I. General information

NPI: 1518211465
Provider Name (Legal Business Name): CAMIE KUO RN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/30/2012
Last Update Date: 11/01/2021
Certification Date: 11/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 GATEWAY BOULEVARD SUITE 100
SOUTH SAN FRANCISCO CA
94080-7408
US

IV. Provider business mailing address

505 PARNASSUS AVE 15 LONG
SAN FRANCISCO CA
94143
US

V. Phone/Fax

Practice location:
  • Phone: 650-826-2937
  • Fax:
Mailing address:
  • Phone: 415-502-4906
  • Fax: 315-514-8192

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95003038
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: