Provider Demographics
NPI:1245018993
Name:IM-GIUFFRIDA, MELISSA ANN (FNP-C)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:ANN
Last Name:IM-GIUFFRIDA
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:193 SAINT GERMAIN AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94114-2131
Mailing Address - Country:US
Mailing Address - Phone:646-867-9520
Mailing Address - Fax:
Practice Address - Street 1:101 8TH ST STE 100
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94607-4707
Practice Address - Country:US
Practice Address - Phone:510-986-6800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-14
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95026514363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner