Provider Demographics
NPI:1891121364
Name:BERNSTEIN, LAUREL KIRBY (CNM, NP)
Entity Type:Individual
Prefix:
First Name:LAUREL
Middle Name:KIRBY
Last Name:BERNSTEIN
Suffix:
Gender:F
Credentials:CNM, NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1413 SAN BRUNO AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-3529
Mailing Address - Country:US
Mailing Address - Phone:443-813-2384
Mailing Address - Fax:
Practice Address - Street 1:1580 VALENCIA ST
Practice Address - Street 2:SUITE 508
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-4423
Practice Address - Country:US
Practice Address - Phone:415-641-6996
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-17
Last Update Date:2013-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2061367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife