Provider Demographics
NPI:1427280833
Name:BOCANEGRA, ABIGAIL MELISSA
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:MELISSA
Last Name:BOCANEGRA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3265 17TH ST
Mailing Address - Street 2:SUITE 404
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-1257
Mailing Address - Country:US
Mailing Address - Phone:415-437-3994
Mailing Address - Fax:415-437-3994
Practice Address - Street 1:3265 17TH ST
Practice Address - Street 2:SUITE 404
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-1257
Practice Address - Country:US
Practice Address - Phone:415-437-3994
Practice Address - Fax:415-437-3994
Is Sole Proprietor?:No
Enumeration Date:2009-08-18
Last Update Date:2009-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program