Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 16135 | CA |
NPI | 1033219621 |
---|---|
Provider Name | Mr. Rex A Saekow |
First Address | San Francisco, CA 94103-2543 |
Second Address | San Francisco, CA 94103 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/09/2006 |
Last Update Date | 18/05/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
16135 | (05) | CA |