Healthcare Provider Details

I. General information

NPI: 1316248180
Provider Name (Legal Business Name): SALENA QUAN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/10/2010
Last Update Date: 01/28/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 DNA WAY
SOUTH SAN FRANCISCO CA
94080-4918
US

IV. Provider business mailing address

1 DNA WAY
SOUTH SAN FRANCISCO CA
94080-4918
US

V. Phone/Fax

Practice location:
  • Phone: 650-225-3039
  • Fax:
Mailing address:
  • Phone: 650-225-3039
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0106X
TaxonomyOccupational Health Nurse Practitioner
License Number20061
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: