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General NPI Number Information
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NPI Number | 1104410885
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Entity Type | Individual
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Provider Name | IRINA GORDON RN MSN CWOCN FNP-C
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Gender | Female
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Dates
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Enumeration Date | 02/24/2021
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Last Update Date | 09/29/2025
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Provider Practice Location Address
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Address Line | 1728 DIVISADERO ST
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City | SAN FRANCISCO
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State | CA
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Zip | 94115-3012
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Country | US
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Telephone | 415-287-0859
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Fax | 415-599-8456
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Provider Business Mailing Address
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Address Line | 7 OAKMONT CT
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City | SAN RAFAEL
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State | CA
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Zip | 94901-1235
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Country | US
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Telephone | 415-867-1815
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95036640
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License Number State | CA
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