Provider Demographics
NPI:1780018259
Name:PELLEGRINI, MARION GIOVANNI FLORENCE (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:MARION
Middle Name:GIOVANNI FLORENCE
Last Name:PELLEGRINI
Suffix:
Gender:M
Credentials:NURSE PRACTITIONER
Other - Prefix:MR
Other - First Name:MARION
Other - Middle Name:
Other - Last Name:PELLIGRINI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:470 CASTRO ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94114-2482
Mailing Address - Country:US
Mailing Address - Phone:415-487-8033
Mailing Address - Fax:
Practice Address - Street 1:470 CASTRO ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94114-2482
Practice Address - Country:US
Practice Address - Phone:415-653-6279
Practice Address - Fax:415-581-1600
Is Sole Proprietor?:No
Enumeration Date:2013-09-02
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
CA752586163W00000X
CA95010221363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No163W00000XNursing Service ProvidersRegistered Nurse