Provider Demographics
NPI:1487075958
Name:STANLEY, NASHANTA D (CLS)
Entity type:Individual
Prefix:MS
First Name:NASHANTA
Middle Name:D
Last Name:STANLEY
Suffix:
Gender:F
Credentials:CLS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 VAN NESS AVE
Mailing Address - Street 2:SUITE 500
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-6033
Mailing Address - Country:US
Mailing Address - Phone:415-437-6261
Mailing Address - Fax:415-431-0352
Practice Address - Street 1:25 VAN NESS AVE
Practice Address - Street 2:SUITE 500
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-6033
Practice Address - Country:US
Practice Address - Phone:415-437-6261
Practice Address - Fax:415-431-0352
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-30
Last Update Date:2013-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA246ZB0600X174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist