Provider Demographics
NPI:1366501215
Name:BERNAL DE PHEILS, PILAR (NP)
Entity Type:Individual
Prefix:
First Name:PILAR
Middle Name:
Last Name:BERNAL DE PHEILS
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 1:59 TAN OAK CIR
Mailing Address - Street 2:
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94903-1725
Mailing Address - Country:US
Mailing Address - Phone:415-476-4588
Mailing Address - Fax:415-753-2161
Practice Address - Street 1:240 SHOTWELL ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-1323
Practice Address - Country:US
Practice Address - Phone:415-552-3870
Practice Address - Fax:415-552-6097
Is Sole Proprietor?:No
Enumeration Date:2006-12-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA292966363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily