Provider Demographics
NPI:1588816656
Name:OMAHONY, JOAN (NP)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:
Last Name:OMAHONY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:513 PARNASSUS AVE UCSF
Mailing Address - Street 2:S-762
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94143
Mailing Address - Country:US
Mailing Address - Phone:650-255-9619
Mailing Address - Fax:415-353-1498
Practice Address - Street 1:500 PARNASSUS AVE
Practice Address - Street 2:MU WEST, MU-425, BOX 0118
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94143-2203
Practice Address - Country:US
Practice Address - Phone:415-353-1606
Practice Address - Fax:415-353-1312
Is Sole Proprietor?:No
Enumeration Date:2008-10-21
Last Update Date:2019-05-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA15305363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
15305OtherNP CA LICENSE