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NPI 1003221102

NPI 1003221102 : SHUK FONG TANG APRN : SAN JOSE, CA

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General NPI Number Information
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    NPI Number           |    1003221102
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    Entity Type          |    Individual 
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    Provider Name        |    SHUK FONG TANG APRN
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    06/26/2014
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    Last Update Date     |    03/14/2025
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Provider Practice Location Address
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    Address Line         |    2150 N 1ST ST FL 2 
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    City                 |    SAN JOSE
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    State                |    CA
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    Zip                  |    95131-2020
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    Country              |    US
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    Telephone            |    415-291-0480
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    Fax                  |    415-252-7176
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Provider Business Mailing Address
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    Address Line         |    1 EMBARCADERO CTR STE 1900 
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    City                 |    SAN FRANCISCO
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    State                |    CA
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    Zip                  |    94111-3723
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    Country              |    US
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    Telephone            |    415-658-6791
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    163W00000X
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    Taxonomy Name        |    Registered Nurse
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    License Number       |    95084957
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    License Number State |    CA
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Taxonomy #2
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    Taxonomy Code        |    363LF0000X
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    Taxonomy Name        |    Family Nurse Practitioner
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    License Number       |    76464
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    License Number State |    KS
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Taxonomy #3
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    Taxonomy Code        |    363LF0000X
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    Taxonomy Name        |    Family Nurse Practitioner
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    License Number       |    95003889
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    License Number State |    CA
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