Provider Demographics
NPI:1194983627
Name:AMIRAULT, REBECCA HESS (CNM)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:HESS
Last Name:AMIRAULT
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3555 CESAR CHAVEZ
Mailing Address - Street 2:SUITE 112
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-4403
Mailing Address - Country:US
Mailing Address - Phone:415-641-6452
Mailing Address - Fax:415-641-6899
Practice Address - Street 1:1580 VALENCIA ST
Practice Address - Street 2:SUITE 508
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-4423
Practice Address - Country:US
Practice Address - Phone:415-641-6996
Practice Address - Fax:415-641-6899
Is Sole Proprietor?:No
Enumeration Date:2008-05-30
Last Update Date:2014-02-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CANMW1772367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
CANMW1772OtherMEDICAL LICENSE