Provider Demographics
NPI:1134491178
Name:ALLOUCHE, ANNA MARIAN (RN, CPNP)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:MARIAN
Last Name:ALLOUCHE
Suffix:
Gender:F
Credentials:RN, CPNP
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:
Other - Last Name:ECKERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:478 WARREN DR APT 713
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94131-1093
Mailing Address - Country:US
Mailing Address - Phone:650-330-7400
Mailing Address - Fax:650-321-1156
Practice Address - Street 1:1885 BAY RD
Practice Address - Street 2:
Practice Address - City:EAST PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94303-1312
Practice Address - Country:US
Practice Address - Phone:650-330-7400
Practice Address - Fax:650-321-1156
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-07
Last Update Date:2015-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA776948163W00000X
CA95002842363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163W00000XNursing Service ProvidersRegistered Nurse