Individual
PHILIPPA VAN DER WAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN CNM
Contact information
Practice address
3260 KERNER BLVD, SAN RAFAEL, CA 94901-4861
(415) 499-4030
(415) 507-2634
Mailing address
3260 KERNER BLVD, SAN RAFAEL, CA 94901-4861
(415) 499-4030
(415) 507-2634
Taxonomy
Speciality
Code
Description
License number
State
163WW0101X
Ambulatory Women's Health Care Registered Nurse
Primary
42195
CA
367A00000X
Advanced Practice Midwife
739
CA
Other
Enumeration date
10/16/2006
Last updated
12/18/2008
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