Basic Information
| Provider Information | |||||||||
| NPI: | 1699223594 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WOFSY | ||||||||
| FirstName: | AVI | ||||||||
| MiddleName: | HELEN | ||||||||
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| Credential: | R.N.- NP.P | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3626 BALBOA ST | ||||||||
| Address2: | |||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941212604 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4156685955 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 3626 BALBOA ST | ||||||||
| Address2: | |||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941212604 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4156685955 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/20/2016 | ||||||||
| LastUpdateDate: | 03/17/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 95069345 | CA | N | Nursing Service Providers | Registered Nurse | 363LP0808X | 95008206 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
No ID Information.