Provider Demographics
NPI:1063027118
Name:GRANADOS DUNCAN, MAURA ANGELICA (FNP)
Entity Type:Individual
Prefix:
First Name:MAURA
Middle Name:ANGELICA
Last Name:GRANADOS DUNCAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:MAURA
Other - Middle Name:ANGELICA
Other - Last Name:GRANADOS GARCIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2233 POST ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-3470
Mailing Address - Country:US
Mailing Address - Phone:415-353-2757
Mailing Address - Fax:
Practice Address - Street 1:2233 POST ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-3470
Practice Address - Country:US
Practice Address - Phone:415-353-2757
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-14
Last Update Date:2022-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95015320207Q00000X
CANP95015320363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine