=====================================================
General NPI Number Information
=====================================================
NPI Number | 1083523682
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ARNULFO DELA CRUZ JR. MSN, MAN, RN
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/02/2026
-----------------------------------------------------
Last Update Date | 09/02/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4150 CLEMENT ST
-----------------------------------------------------
City | SAN FRANCISCO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94121-1563
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 415-221-4810
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4615 WESTBROOK RD
-----------------------------------------------------
City | BARTLETT
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 38135-1306
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 901-337-4738
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163W00000X
-----------------------------------------------------
Taxonomy Name | Registered Nurse
-----------------------------------------------------
License Number | 131032
-----------------------------------------------------
License Number State | TN
-----------------------------------------------------