Provider Demographics
NPI:1720267545
Name:HANEY, MARIA ELENA (RN, PHN, CNS)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:ELENA
Last Name:HANEY
Suffix:
Gender:F
Credentials:RN, PHN, CNS
Other - Prefix:MRS
Other - First Name:MARIA
Other - Middle Name:ELENA
Other - Last Name:MOLINA-HANLEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN, PHN, CNS
Mailing Address - Street 1:635 POTRERO AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-2116
Mailing Address - Country:US
Mailing Address - Phone:415-206-6756
Mailing Address - Fax:415-206-6653
Practice Address - Street 1:635 POTRERO AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-2116
Practice Address - Country:US
Practice Address - Phone:415-206-6756
Practice Address - Fax:415-206-6653
Is Sole Proprietor?:No
Enumeration Date:2007-10-29
Last Update Date:2007-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA405230163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management