Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | 20405 | CA |
N | 363LA2200X | Nurse Practitioner - Adult Health | 20405 | CA |
N | 363LC1500X | Nurse Practitioner - Community Health | 20405 | CA |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 20405 | CA |
N | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 20405 | CA |
N | 363LP2300X | Nurse Practitioner - Primary Care | 20405 | CA |
N | 363LX0106X | Nurse Practitioner - Occupational Health | 20405 | CA |
NPI | 1194952218 |
---|---|
Provider Name | Sam Ustrzynski |
First Address | San Francisco, CA 94147-5251 |
Second Address | San Francisco, CA 94120 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2009 |
Last Update Date | 03/11/2014 |