Provider Demographics
NPI:1699164210
Name:NILES, EMILY
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:NILES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SKYE
Other - Middle Name:
Other - Last Name:NEWLANDS-NILES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:42 WASHBURN ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-2663
Mailing Address - Country:US
Mailing Address - Phone:415-864-8701
Mailing Address - Fax:
Practice Address - Street 1:42 WASHBURN ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-2663
Practice Address - Country:US
Practice Address - Phone:415-864-8701
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-20
Last Update Date:2015-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor