Basic Information
| Provider Information | |||||||||
| NPI: | 1285101956 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TINSLEY | ||||||||
| FirstName: | EBONY | ||||||||
| MiddleName: | YVONNE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 442 SPRING ST | ||||||||
| Address2: | |||||||||
| City: | RICHMOND | ||||||||
| State: | CA | ||||||||
| PostalCode: | 948042936 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5104171492 | ||||||||
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| Practice Location | |||||||||
| Address1: | 26 CALIFORNIA ST | ||||||||
| Address2: | |||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941114803 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4157817077 | ||||||||
| FaxNumber: | 4156210611 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/30/2018 | ||||||||
| LastUpdateDate: | 10/30/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | PA56153 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.