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General NPI Number Information
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NPI Number | 1831221860
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Entity Type | Individual
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Provider Name | PRISCILLA ANN WHEELER PA
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Gender | Female
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Dates
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Enumeration Date | 03/13/2007
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Last Update Date | 08/11/2009
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Provider Practice Location Address
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Address Line | 15400 FOOTHILL BLVD
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City | SAN LEANDRO
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State | CA
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Zip | 94578-1009
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Country | US
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Telephone | 510-895-4353
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Fax |
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Provider Business Mailing Address
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Address Line | 2430 LARKIN ST
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City | SAN FRANCISCO
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State | CA
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Zip | 94109-1726
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Country | US
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Telephone | 415-563-2346
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA11555
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License Number State | CA
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