Provider Demographics
NPI:1376618249
Name:WALGENBACH, ANN WILLIAMSON (RN, FNP, MSN, RNFA)
Entity Type:Individual
Prefix:MRS
First Name:ANN
Middle Name:WILLIAMSON
Last Name:WALGENBACH
Suffix:
Gender:F
Credentials:RN, FNP, MSN, RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7570 ALTURA PL
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94605-3108
Mailing Address - Country:US
Mailing Address - Phone:510-632-1190
Mailing Address - Fax:510-569-6206
Practice Address - Street 1:3727 BUCHANAN ST STE 300
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94123-1779
Practice Address - Country:US
Practice Address - Phone:415-563-3110
Practice Address - Fax:415-563-3301
Is Sole Proprietor?:No
Enumeration Date:2006-11-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA319640363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily