Provider Demographics
NPI:1568510204
Name:FAUST, SHOTSY C (NP MSN)
Entity Type:Individual
Prefix:MS
First Name:SHOTSY
Middle Name:C
Last Name:FAUST
Suffix:
Gender:F
Credentials:NP MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:995 POTRERO AVE # 83
Mailing Address - Street 2:SFGH FHC
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-2859
Mailing Address - Country:US
Mailing Address - Phone:415-206-6496
Mailing Address - Fax:415-206-5855
Practice Address - Street 1:995 POTRERO AVE # 83
Practice Address - Street 2:SFGH FHC
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-2859
Practice Address - Country:US
Practice Address - Phone:415-206-6496
Practice Address - Fax:415-206-5855
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN354652163WC1500X
CANPF3043363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
Not Answered363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
030007OtherSFGH INTERNAL USE ONLY-COMMERCIAL NUMBER
030007OtherSFGH INTERNAL USE ONLY-COMMERCIAL NUMBER