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NPI 1083179048

NPI 1083179048 : MARIA RANGEL : SAN FRANCISCO, CA

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General NPI Number Information
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    NPI Number           |    1083179048
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    Entity Type          |    Individual 
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    Provider Name        |    MARIA RANGEL
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    02/04/2019
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    Last Update Date     |    02/03/2020
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Provider Practice Location Address
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    Address Line         |    1801 VICENTE ST 
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    City                 |    SAN FRANCISCO
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    State                |    CA
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    Zip                  |    94116-2923
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    Country              |    US
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    Telephone            |    415-681-3211
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    3232 14TH AVE APT 16 
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    City                 |    OAKLAND
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    State                |    CA
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    Zip                  |    94602-1063
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    Country              |    US
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    Telephone            |    510-421-7703
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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        |    172V00000X
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    Taxonomy Name        |    Community Health Worker
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    106S00000X
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    Taxonomy Name        |    Behavior Technician
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    License Number       |    
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    License Number State |    
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