Provider Demographics
NPI:1124391701
Name:ANDREATTA, DENNIS (RN, MSN, CRRN, PHN)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:
Last Name:ANDREATTA
Suffix:
Gender:M
Credentials:RN, MSN, CRRN, PHN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:548 BURROWS ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94134-1422
Mailing Address - Country:US
Mailing Address - Phone:415-830-0108
Mailing Address - Fax:
Practice Address - Street 1:548 BURROWS ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94134-1422
Practice Address - Country:US
Practice Address - Phone:415-830-0108
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-13
Last Update Date:2012-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA474528163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health