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General NPI Number Information
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NPI Number | 1285791962
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Entity Type | Individual
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Provider Name | SHELLEY HOM RN, NP, CS
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Gender | Female
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Dates
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Enumeration Date | 01/02/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3905 MISSION ST
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City | SAN FRANCISCO
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State | CA
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Zip | 94112-1014
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Country | US
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Telephone | 415-337-2400
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Fax | 415-337-2415
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Provider Business Mailing Address
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Address Line | 1791 17TH AVE
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City | SAN FRANCISCO
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State | CA
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Zip | 94122-4501
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Country | US
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Telephone | 415-664-8807
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 11079
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License Number State | CA
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