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General NPI Number Information
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NPI Number | 1134265200
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Entity Type | Individual
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Provider Name | NANCY MICHIE OKUMURA
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Gender | Female
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Dates
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Enumeration Date | 01/29/2007
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Last Update Date | 12/30/2021
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Provider Practice Location Address
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Address Line | 350 SAINT JOSEPHS AVE
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City | SAN FRANCISCO
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State | CA
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Zip | 94115-3255
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Country | US
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Telephone | 415-833-4683
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Fax |
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Provider Business Mailing Address
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Address Line | 1635 DIVISADERO ST STE 300
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City | SAN FRANCISCO
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State | CA
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Zip | 94115-3043
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Country | US
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Telephone | 415-833-4683
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 11303
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License Number State | CA
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