Individual
HENRIETTA CHINASA ANIBUKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1001 POTRERO AVE # WARD93, SAN FRANCISCO, CA 94110-3518
(628) 206-8412
Mailing address
995 POTRERO AVE # WARD93, SAN FRANCISCO, CA 94110-2859
(628) 206-3364
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
95214118
CA
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
95214118
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
59771
—
CA
Enumeration date
12/08/2020
Last updated
05/29/2025
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