Provider Demographics
NPI:1437039963
Name:BAHENA, ANA LAURA
Entity type:Individual
Prefix:
First Name:ANA
Middle Name:LAURA
Last Name:BAHENA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 BLANKEN AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94134-2407
Mailing Address - Country:US
Mailing Address - Phone:628-271-7003
Mailing Address - Fax:
Practice Address - Street 1:1525 SILVER AVE FL 2
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94134-1229
Practice Address - Country:US
Practice Address - Phone:628-271-7003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-04
Last Update Date:2025-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker