Provider Demographics
NPI:1023179447
Name:IGNATOVA, ANNA (GNP)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:IGNATOVA
Suffix:
Gender:F
Credentials:GNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 S VAN NESS AVE
Mailing Address - Street 2:APT 407
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-1388
Mailing Address - Country:US
Mailing Address - Phone:415-833-2426
Mailing Address - Fax:415-833-2715
Practice Address - Street 1:505 PARNASSUS AVE, L1556
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94143
Practice Address - Country:US
Practice Address - Phone:415-260-5616
Practice Address - Fax:415-514-8192
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2023-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12785363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAQ05016Medicare UPIN