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General NPI Number Information
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NPI Number | 1811462310
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Entity Type | Individual
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Provider Name | PATRICIA KELLEHER TYNAN AGNP
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Gender | Female
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Dates
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Enumeration Date | 10/10/2018
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Last Update Date | 11/12/2025
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Provider Practice Location Address
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Address Line | 7881 EDINGER AVE STE 124
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92647-7647
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Country | US
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Telephone | 888-663-6331
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Fax | 415-252-7176
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Provider Business Mailing Address
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Address Line | 1 EMBARCADERO CTR STE 1900
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City | SAN FRANCISCO
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State | CA
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Zip | 94111-3723
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Country | US
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Telephone |
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | NP95009415
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 95009415
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License Number State | CA
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