Provider Demographics
NPI:1598155392
Name:GRAZUTIS, ANGELIKA VITALIA (FNP)
Entity Type:Individual
Prefix:MS
First Name:ANGELIKA
Middle Name:VITALIA
Last Name:GRAZUTIS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1212 10TH AVE APT 304
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94122-2325
Mailing Address - Country:US
Mailing Address - Phone:415-533-1914
Mailing Address - Fax:
Practice Address - Street 1:2800 LEAVENWORTH ST STE 350B
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94133-1121
Practice Address - Country:US
Practice Address - Phone:415-749-4200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-31
Last Update Date:2015-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA634301163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health