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Individual

LISA DICOSTANZO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1101 VAN NESS AVE, SAN FRANCISCO, CA 94109-6919
(510) 435-3062
Mailing address
2226 BUENA VISTA AVE, ALAMEDA, CA 94501-1423

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
95025651
CA

Other

Enumeration date
01/05/2024
Last updated
01/05/2024
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