Provider Demographics
NPI:1952510737
Name:COOMBS, LORINDA A (NP)
Entity Type:Individual
Prefix:MS
First Name:LORINDA
Middle Name:A
Last Name:COOMBS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 POTRERO AVE
Mailing Address - Street 2:SFGH UNIT 4C
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-3518
Mailing Address - Country:US
Mailing Address - Phone:415-206-6896
Mailing Address - Fax:415-206-3615
Practice Address - Street 1:1001 POTRERO AVE
Practice Address - Street 2:SFGH UNIT 4C
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-3518
Practice Address - Country:US
Practice Address - Phone:415-206-6896
Practice Address - Fax:415-206-3615
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2012-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA540407163W00000X
CA14119363L00000X
CA1046364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAQ14572Medicare UPIN