Provider Demographics
NPI:1699917799
Name:VERSTRAETE, SOFIA GUADALUPE (MD)
Entity type:Individual
Prefix:
First Name:SOFIA
Middle Name:GUADALUPE
Last Name:VERSTRAETE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SOFIA
Other - Middle Name:GUADALUPE
Other - Last Name:SANCHEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:500 PARNASSUS AVE
Mailing Address - Street 2:MU408E BOX0136
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94143-0136
Mailing Address - Country:US
Mailing Address - Phone:415-476-5892
Mailing Address - Fax:415-476-1343
Practice Address - Street 1:500 PARNASSUS AVE
Practice Address - Street 2:MU408E BOX 0136
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94143-2203
Practice Address - Country:US
Practice Address - Phone:415-476-5892
Practice Address - Fax:415-476-1343
Is Sole Proprietor?:No
Enumeration Date:2009-04-03
Last Update Date:2014-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program