MEDICARE: ROCHELLE NEUTRA RN, FNP

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
1	363LF0000X	Family Nurse Practitioner	557996	CA

General Provider Information

NPI Number	:	1396745642
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROCHELLE NEUTRA RN, FNP

Provider Business Mailing Address
First Line	:	956 EVELYN AVE
Second Line	:
City	:	ALBANY
State	:	CA
Zip	:	94706-2014
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	995 POTRERO AVE # WARD83
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94110-2859
Country	:	US
Telephone Number	:	415-206-8000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/28/2005
Last Update Date	:	07/25/2015

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