Provider Demographics
NPI:1740579416
Name:O'BRIEN, COLETTE ROXANNE (CPNP)
Entity Type:Individual
Prefix:MRS
First Name:COLETTE
Middle Name:ROXANNE
Last Name:O'BRIEN
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
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Mailing Address - Street 1:1500 OWENS ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94158-2334
Mailing Address - Country:US
Mailing Address - Phone:415-514-6234
Mailing Address - Fax:415-353-2811
Practice Address - Street 1:1500 OWENS ST
Practice Address - Street 2:SUITE 300
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94158-2334
Practice Address - Country:US
Practice Address - Phone:415-514-6234
Practice Address - Fax:415-353-2811
Is Sole Proprietor?:No
Enumeration Date:2011-04-04
Last Update Date:2013-11-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA493521363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics