Basic Information
Provider Information
NPI: 1093365454
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HACKMAN
FirstName: SYLVIA
MiddleName: DENISE
NamePrefix: MISS
NameSuffix:  
Credential: NURSING (L.V.N.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1111 MARKET ST
Address2:  
City: SAN FRANCISCO
State: CA
PostalCode: 941031509
CountryCode: US
TelephoneNumber: 4158633883
FaxNumber: 4158637343
Practice Location
Address1: 1111 MARKET ST
Address2:  
City: SAN FRANCISCO
State: CA
PostalCode: 941031509
CountryCode: US
TelephoneNumber: 4158633883
FaxNumber: 4158637343
Other Information
ProviderEnumerationDate: 09/18/2019
LastUpdateDate: 09/18/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
164X00000X294936CAY Nursing Service ProvidersLicensed Vocational Nurse 

No ID Information.


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