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NPI Code Detail

MEDICARE: MS. KRISTIN ALDERISIO PA-C

MEDICARE: MS. KRISTIN ALDERISIO PA-C
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
1172V00000XCommunity Health Worker
2363AS0400XSurgical Physician AssistantPA16413CA

General Provider Information

NPI Number : 1669535258
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KRISTIN ALDERISIO PA-C
Provider Business Mailing Address
First Line : 368 FELL ST
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94102-5144
Country : US
Telephone Number : 415-861-0828
Fax Number :
Provider Business Practice Location Address
First Line : 368 FELL ST
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94102-5144
Country : US
Telephone Number : 415-861-0828
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/18/2006
Last Update Date : 04/01/2025

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