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General NPI Number Information
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NPI Number | 1154652691
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Entity Type | Individual
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Provider Name | KRISTIE K THEIS CNS
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Gender | Female
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Dates
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Enumeration Date | 01/22/2010
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Last Update Date | 01/22/2010
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Provider Practice Location Address
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Address Line | 2425 GEARY BLVD
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City | SAN FRANCISCO
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State | CA
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Zip | 94115-3358
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Country | US
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Telephone | 415-310-0944
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Fax |
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Provider Business Mailing Address
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Address Line | 735 THORNHILL DR
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City | DALY CITY
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State | CA
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Zip | 94015-3647
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Country | US
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Telephone | 415-310-0944
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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 | 636031
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 364S00000X
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Taxonomy Name | Clinical Nurse Specialist
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License Number | 3207
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License Number State | CA
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