Provider Demographics
NPI:1427453323
Name:PRIMO HEALTH COACH, INC.
Entity type:Organization
Organization Name:PRIMO HEALTH COACH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICAL NUTRITIONIST
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SANELLI
Authorized Official - Suffix:
Authorized Official - Credentials:MSC
Authorized Official - Phone:415-754-3047
Mailing Address - Street 1:PO BOX 401195
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94140-1195
Mailing Address - Country:US
Mailing Address - Phone:415-754-3047
Mailing Address - Fax:415-358-5619
Practice Address - Street 1:2460 MISSION ST STE 214
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-2458
Practice Address - Country:US
Practice Address - Phone:415-754-3047
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-04
Last Update Date:2016-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management