Provider Demographics
NPI:1326193756
Name:MCSPADDEN, COURTNEY (NP)
Entity Type:Individual
Prefix:MS
First Name:COURTNEY
Middle Name:
Last Name:MCSPADDEN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 WEBSTER STREET
Mailing Address - Street 2:SUITE 506
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115
Mailing Address - Country:US
Mailing Address - Phone:415-923-3067
Mailing Address - Fax:415-346-5019
Practice Address - Street 1:2100 WEBSTER STREET
Practice Address - Street 2:SUITE 506
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115
Practice Address - Country:US
Practice Address - Phone:415-923-3067
Practice Address - Fax:415-346-5019
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2013-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA665017363LW0102X
CA17123363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health