Provider Demographics
NPI:1245866631
Name:WESSEH, PRINCESS AT (RN)
Entity type:Individual
Prefix:
First Name:PRINCESS
Middle Name:AT
Last Name:WESSEH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:PRINCESS
Other - Middle Name:AT
Other - Last Name:KOFFA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:368 FELL ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-5144
Mailing Address - Country:US
Mailing Address - Phone:415-861-0828
Mailing Address - Fax:415-861-0140
Practice Address - Street 1:52 DORE ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-3828
Practice Address - Country:US
Practice Address - Phone:415-861-0828
Practice Address - Fax:415-861-0140
Is Sole Proprietor?:No
Enumeration Date:2020-03-17
Last Update Date:2022-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95213487163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse