Provider Demographics
NPI:1083804983
Name:PFERDEHIRT, BETH RACHEL (FNP)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:RACHEL
Last Name:PFERDEHIRT
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:559 CLAY ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94111-3029
Mailing Address - Country:US
Mailing Address - Phone:415-644-5265
Mailing Address - Fax:415-291-0489
Practice Address - Street 1:559 CLAY ST
Practice Address - Street 2:SUITE 200
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94111-3029
Practice Address - Country:US
Practice Address - Phone:415-644-5265
Practice Address - Fax:415-291-0489
Is Sole Proprietor?:No
Enumeration Date:2007-07-26
Last Update Date:2012-05-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA17345363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily