Provider Demographics
NPI:1861818247
Name:TODD, AUDRIANA (NP-C)
Entity Type:Individual
Prefix:
First Name:AUDRIANA
Middle Name:
Last Name:TODD
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:AUDRIANA
Other - Middle Name:
Other - Last Name:GOMEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN-BC
Mailing Address - Street 1:325 DISTEL CIR
Mailing Address - Street 2:
Mailing Address - City:LOS ALTOS
Mailing Address - State:CA
Mailing Address - Zip Code:94022-1408
Mailing Address - Country:US
Mailing Address - Phone:415-600-3503
Mailing Address - Fax:415-600-1327
Practice Address - Street 1:2300 CALIFORNIA ST
Practice Address - Street 2:SUITE 103
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-2753
Practice Address - Country:US
Practice Address - Phone:415-600-3503
Practice Address - Fax:415-600-1327
Is Sole Proprietor?:No
Enumeration Date:2014-03-10
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA817757163W00000X
CA95018814363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA95018814OtherNP LICENSE