Provider Demographics
NPI:1245398577
Name:KAISER SAN FRANCISCO
Entity Type:Organization
Organization Name:KAISER SAN FRANCISCO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PEDIATRIC NURSE PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:SUZANNE
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MSN
Authorized Official - Phone:415-833-2000
Mailing Address - Street 1:62 INVERNESS DR
Mailing Address - Street 2:
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94901-2418
Mailing Address - Country:US
Mailing Address - Phone:415-457-4823
Mailing Address - Fax:415-457-4823
Practice Address - Street 1:2245 GEARY STREET
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115
Practice Address - Country:US
Practice Address - Phone:415-833-2000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAB333360302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization