Basic Information
| Provider Information | |||||||||
| NPI: | 1447287917 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TIERNEY | ||||||||
| FirstName: | MATTHEW | ||||||||
| MiddleName: | JOSEPH | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | N.P., M.S.N., R.N. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 239 ROOSEVELT WAY | ||||||||
| Address2: | |||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941141431 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4155525859 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1001 POTRERO AVE | ||||||||
| Address2: | SAN FRANCISCO GENERAL HOSPITAL, DEPT. OF PSYCHIATRY | ||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941103518 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4152064310 | ||||||||
| FaxNumber: | 4152066875 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/28/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WM0705X | RN546728 | CA | X | Nursing Service Providers | Registered Nurse | Medical-Surgical | 363LP0808X | NPF11973 | CA | X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
No ID Information.