Provider Demographics
NPI:1194845651
Name:LUU, ELAINE (FNP, CNS, RN)
Entity Type:Individual
Prefix:
First Name:ELAINE
Middle Name:
Last Name:LUU
Suffix:
Gender:F
Credentials:FNP, CNS, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1283 37TH AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94122-1332
Mailing Address - Country:US
Mailing Address - Phone:415-637-9492
Mailing Address - Fax:
Practice Address - Street 1:5 BON AIR RD STE 150
Practice Address - Street 2:
Practice Address - City:LARKSPUR
Practice Address - State:CA
Practice Address - Zip Code:94939-1143
Practice Address - Country:US
Practice Address - Phone:415-945-7800
Practice Address - Fax:415-924-6607
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2526364SM0705X
CA15548363LF0000X
CA633051163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No364SM0705XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistMedical-Surgical
No163W00000XNursing Service ProvidersRegistered Nurse