Individual
GRACE MARIE SEVILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
400 PARNASSUS AVE FL 4, SAN FRANCISCO, CA 94143-2202
(415) 353-2421
Mailing address
400 PARNASSUS AVE FL 4, SAN FRANCISCO, CA 94143-2202
(415) 353-2421
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA61726
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1245636950
—
WA
Enumeration date
11/06/2014
Last updated
05/28/2024
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