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General NPI Number Information
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NPI Number | 1841828720
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Entity Type | Individual
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Provider Name | KRISTEN ELIZABETH MENGWASSER
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Gender | Female
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Dates
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Enumeration Date | 03/27/2020
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Last Update Date | 07/01/2025
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Provider Practice Location Address
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Address Line | 1001 POTRERO AVENUE BLDG 90 FL2
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City | SAN FRANCISCO
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State | CA
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Zip | 94110
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Country | US
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Telephone | 628-206-4777
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Fax | 628-206-4257
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Provider Business Mailing Address
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Address Line | 33 POND AVE APT 1006
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City | BROOKLINE
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State | MA
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Zip | 02445-7158
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Country | US
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Telephone | 314-809-8201
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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 | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | A180354
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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