Provider Demographics
NPI:1366766453
Name:GIRAUDO, COURTNEY LENNON (CPNP)
Entity type:Individual
Prefix:MRS
First Name:COURTNEY
Middle Name:LENNON
Last Name:GIRAUDO
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1625 VAN NESS AVENUE
Mailing Address - Street 2:3RD FLR, CALIFORNIA PACIFIC MEDICAL CTR
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94120
Mailing Address - Country:US
Mailing Address - Phone:415-600-0830
Mailing Address - Fax:415-731-2314
Practice Address - Street 1:1625 VAN NESS AVENUE
Practice Address - Street 2:3RD FLR, CALIFORNIA PACIFIC MEDICAL CTR
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94120
Practice Address - Country:US
Practice Address - Phone:415-600-0830
Practice Address - Fax:415-731-2314
Is Sole Proprietor?:No
Enumeration Date:2010-03-18
Last Update Date:2010-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN570791163W00000X
CANP15098363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163W00000XNursing Service ProvidersRegistered Nurse