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General NPI Number Information
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NPI Number | 1912258369
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Entity Type | Organization
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Legal Business Name | LONG TERM CARE PSYCHIATRY NURSING CORPORATION
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Dates
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Enumeration Date | 09/25/2012
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Last Update Date | 01/22/2013
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Provider Practice Location Address
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Address Line | 46 CRAGMONT AVE
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City | SAN FRANCISCO
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State | CA
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Zip | 94116-1308
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Country | US
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Telephone | 415-823-5131
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Fax |
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Provider Business Mailing Address
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Address Line | 46 CRAGMONT AVE
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City | SAN FRANCISCO
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State | CA
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Zip | 94116-1308
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Country | US
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Telephone | 415-823-5131
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | WILLIAM B FALK
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Credential | NP
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Telephone | 415-528-0532
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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 | 14427
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License Number State | CA
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