Provider Demographics
NPI:1891440996
Name:GANESH, GOPIKA KRISHNA (RN, CNS)
Entity Type:Individual
Prefix:MS
First Name:GOPIKA
Middle Name:KRISHNA
Last Name:GANESH
Suffix:
Gender:F
Credentials:RN, CNS
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:308 CAPITOL AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94112-2933
Mailing Address - Country:US
Mailing Address - Phone:214-448-5816
Mailing Address - Fax:
Practice Address - Street 1:99 MONTECILLO RD
Practice Address - Street 2:
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94903-3308
Practice Address - Country:US
Practice Address - Phone:415-444-3135
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-16
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA95104047163W00000X
CA4968364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
No163W00000XNursing Service ProvidersRegistered Nurse