Provider Demographics
NPI:1063813350
Name:DEAN, URSULA (BSN, RN, MSN, NP)
Entity type:Individual
Prefix:MS
First Name:URSULA
Middle Name:
Last Name:DEAN
Suffix:
Gender:F
Credentials:BSN, RN, MSN, NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:819 N HUMBOLDT ST APT 206
Mailing Address - Street 2:
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94401-1413
Mailing Address - Country:US
Mailing Address - Phone:626-818-1339
Mailing Address - Fax:
Practice Address - Street 1:900 WELCH RD STE 350
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94304-1807
Practice Address - Country:US
Practice Address - Phone:650-724-3254
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-06
Last Update Date:2014-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA627108163W00000X
CA18423363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse