Provider Demographics
NPI:1952556367
Name:TAN, SHIRLEY T
Entity Type:Individual
Prefix:
First Name:SHIRLEY
Middle Name:T
Last Name:TAN
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 1:30 VAN NESS AVE STE 2300
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-6081
Mailing Address - Country:US
Mailing Address - Phone:415-581-2427
Mailing Address - Fax:415-581-2498
Practice Address - Street 1:30 VAN NESS AVE STE 2300
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-6081
Practice Address - Country:US
Practice Address - Phone:415-581-2427
Practice Address - Fax:415-581-2498
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-26
Last Update Date:2008-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator