Provider Demographics
| NPI: | 1174486377 |
|---|---|
| Name: | PAPP-VANCELLETTE, ELIZABETH |
| Entity type: | Individual |
| Prefix: | |
| First Name: | ELIZABETH |
| Middle Name: | |
| Last Name: | PAPP-VANCELLETTE |
| Suffix: | |
| Gender: | F |
| Credentials: | |
| Other - Prefix: | |
| Other - First Name: | ELIZABETH |
| Other - Middle Name: | |
| Other - Last Name: | PAPP |
| Other - Suffix: | |
| Other - Last Name Type: | Former Name |
| Other - Credentials: | |
| Mailing Address - Street 1: | 2434 32ND AVE |
| Mailing Address - Street 2: | |
| Mailing Address - City: | SAN FRANCISCO |
| Mailing Address - State: | CA |
| Mailing Address - Zip Code: | 94116-2237 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | 1975 4TH ST |
| Practice Address - Street 2: | |
| Practice Address - City: | SAN FRANCISCO |
| Practice Address - State: | CA |
| Practice Address - Zip Code: | 94143-2351 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 415-353-8847 |
| Practice Address - Fax: | |
| Is Sole Proprietor?: | No |
| Enumeration Date: | 2025-12-04 |
| Last Update Date: | 2025-12-04 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Licenses
| State | License ID | Taxonomies |
|---|---|---|
| CA | 720766 | 163WN0002X |
| CA | 22287 | 363LF0000X |
| CA | 4746 | 364S00000X |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization |
|---|---|---|---|---|
| Yes | 364S00000X | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist | |
| No | 163WN0002X | Nursing Service Providers | Registered Nurse | Neonatal Intensive Care |
| No | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |