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General NPI Number Information
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NPI Number | 1730807769
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Entity Type | Individual
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Provider Name | CRYSTAL L UKEN NP
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Gender | Female
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Dates
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Enumeration Date | 08/16/2022
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Last Update Date | 04/22/2023
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Provider Practice Location Address
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Address Line | 150 GOLDEN GATE AVE
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City | SAN FRANCISCO
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State | CA
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Zip | 94102-3810
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Country | US
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Telephone | 415-241-2600
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Fax |
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Provider Business Mailing Address
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Address Line | 4014 WALNUT ST
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City | OAKLAND
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State | CA
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Zip | 94619-1739
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Country | US
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Telephone | 415-260-5455
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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 | 95019845
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License Number State | CA
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