Provider Demographics
NPI:1205236064
Name:ULLRICH, DENISE
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:ULLRICH
Suffix:
Gender:F
Credentials:
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
Mailing Address - Street 2:DEPT. OF PSYCH, 7TH FLOOR, ED CASE MANAGEMENT
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110
Mailing Address - Country:US
Mailing Address - Phone:619-233-3302
Mailing Address - Fax:
Practice Address - Street 1:1001 POTRERO
Practice Address - Street 2:DEPT. OF PSYCH, 7TH FLOOR, ED CASE MANAGEMENT
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110
Practice Address - Country:US
Practice Address - Phone:619-233-3302
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-29
Last Update Date:2014-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program