Provider Demographics
NPI:1598915852
Name:PARKER, RYAN NELSON
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:NELSON
Last Name:PARKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 EXECUTIVE PARK BLVD
Mailing Address - Street 2:SUITE 4900
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94134-3394
Mailing Address - Country:US
Mailing Address - Phone:415-656-0116
Mailing Address - Fax:415-656-0117
Practice Address - Street 1:250 EXECUTIVE PARK BLVD
Practice Address - Street 2:SUITE 4900
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94134-3394
Practice Address - Country:US
Practice Address - Phone:415-656-0116
Practice Address - Fax:415-656-0117
Is Sole Proprietor?:No
Enumeration Date:2008-09-23
Last Update Date:2011-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor