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General NPI Number Information
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NPI Number | 1952060899
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Entity Type | Individual
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Provider Name | LAURA KATHRYN CICCHETTI CNM, WHNP
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Gender | Female
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Dates
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Enumeration Date | 12/08/2021
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Last Update Date | 12/08/2021
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Provider Practice Location Address
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Address Line | 1522 BUSH ST
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City | SAN FRANCISCO
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State | CA
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Zip | 94109-5420
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Country | US
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Telephone | 415-821-1282
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Fax |
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Provider Business Mailing Address
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Address Line | 678 WALLER ST
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City | SAN FRANCISCO
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State | CA
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Zip | 94117-3321
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Country | US
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Telephone | 401-524-8968
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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 | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | NP95017519
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | NMW236194
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License Number State | CA
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