Provider Demographics
NPI:1891832358
Name:PHOENIX, BETHANY JOYCE (RN, CNS)
Entity Type:Individual
Prefix:DR
First Name:BETHANY
Middle Name:JOYCE
Last Name:PHOENIX
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Gender:F
Credentials:RN, CNS
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Mailing Address - Street 1:2 KORET WAY, DEPT. OF COMMUNITY HEALTH SYSTEMS
Mailing Address - Street 2:UCSF BOX 0608
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94143-0608
Mailing Address - Country:US
Mailing Address - Phone:415-502-4407
Mailing Address - Fax:415-476-6042
Practice Address - Street 1:3180 18TH ST
Practice Address - Street 2:STE. 202
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-2043
Practice Address - Country:US
Practice Address - Phone:415-502-5777
Practice Address - Fax:415-502-5764
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
CA331209163WP0808X
CA1036364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
Not Answered364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health