Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 95014089 | CA |
NPI | 1033717194 |
---|---|
Provider Name | Ana Cecilia Trejo |
First Address | San Francisco, CA 94123-3438 |
Second Address | San Francisco, CA 94143-2204 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2020 |
Last Update Date | 12/10/2020 |