Provider Demographics
NPI:1003183708
Name:GOLDSTEIN, ELISABETH LESLIE (RN, NP)
Entity Type:Individual
Prefix:
First Name:ELISABETH
Middle Name:LESLIE
Last Name:GOLDSTEIN
Suffix:
Gender:F
Credentials:RN, NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1171 MISSION ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-1519
Mailing Address - Country:US
Mailing Address - Phone:415-734-4231
Mailing Address - Fax:415-734-4218
Practice Address - Street 1:1171 MISSION ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-1519
Practice Address - Country:US
Practice Address - Phone:415-734-4231
Practice Address - Fax:415-734-4218
Is Sole Proprietor?:No
Enumeration Date:2011-11-23
Last Update Date:2016-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA730174163W00000X
CA19981363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse