Individual
NEGIN FAZILAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1001 POTRERO AVE, SAN FRANCISCO, CA 94110-3518
(628) 206-8000
Mailing address
1245 PORTLAND AVE, LOS ALTOS, CA 94024-5520
(650) 557-8252
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
95009886
CA
Other
Enumeration date
11/08/2018
Last updated
01/01/2019
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