Provider Demographics
NPI:1891589685
Name:DISTEFANO, ANNA (RDN)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:DISTEFANO
Suffix:
Gender:
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 VAN NESS AVE APT 1515
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-5222
Mailing Address - Country:US
Mailing Address - Phone:707-334-2925
Mailing Address - Fax:
Practice Address - Street 1:100 VAN NESS AVE APT 1515
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-5222
Practice Address - Country:US
Practice Address - Phone:707-334-2925
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer