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General NPI Number Information
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NPI Number | 1174320022
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Entity Type | Organization
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Legal Business Name | RADIANT WOMENS HEALTH - PALO ALTO INC
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Dates
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Enumeration Date | 02/27/2025
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Last Update Date | 02/27/2025
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Provider Practice Location Address
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Address Line | 150 PORTOLA RD STE A
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City | PORTOLA VALLEY
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State | CA
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Zip | 94028-7852
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Country | US
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Telephone | 650-585-3272
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Fax | 650-860-1830
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Provider Business Mailing Address
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Address Line | 3749 BUCHANAN ST # 475054
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City | SAN FRANCISCO
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State | CA
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Zip | 94123-1710
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Country | US
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Telephone | 650-585-3272
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Fax | 650-860-1830
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. JESSICA KASSIS
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Credential | MD
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Telephone | 650-504-0294
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number |
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License Number State |
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