Provider Demographics
NPI:1306010442
Name:GRAY, BETH MAUREEN (RN MS CNS)
Entity Type:Individual
Prefix:MS
First Name:BETH
Middle Name:MAUREEN
Last Name:GRAY
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Gender:F
Credentials:RN MS CNS
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Mailing Address - Street 1:1001 PORTRERO AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-3518
Mailing Address - Country:US
Mailing Address - Phone:415-206-4511
Mailing Address - Fax:415-206-3177
Practice Address - Street 1:1001 PORTRERO AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-3518
Practice Address - Country:US
Practice Address - Phone:415-206-4511
Practice Address - Fax:415-206-3177
Is Sole Proprietor?:No
Enumeration Date:2008-04-19
Last Update Date:2012-02-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA244603163WP0809X, 163WH0200X
CA3016364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health
No163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
No163WH0200XNursing Service ProvidersRegistered NurseHome Health