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NPI Code Detail

MEDICARE: STOOP NILSSON LPT

MEDICARE: STOOP NILSSON LPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor31138CA

General Provider Information

NPI Number : 1073650529
Entity Type Code : Individual
Provider Name (Legal Business Name) : STOOP NILSSON LPT
Provider Business Mailing Address
First Line : 2059 FULTON ST
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94117-1119
Country : US
Telephone Number : 415-678-8290
Fax Number :
Provider Business Practice Location Address
First Line : 52 DORE ST
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94103-3828
Country : US
Telephone Number : 415-553-3100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/31/2007
Last Update Date : 05/30/2012

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Directions to “ STOOP NILSSON LPT” Practice Location

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