Provider Demographics
NPI:1538358650
Name:UYBICO, STACY JOAN (MD)
Entity type:Individual
Prefix:
First Name:STACY
Middle Name:JOAN
Last Name:UYBICO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6102
Mailing Address - Street 2:
Mailing Address - City:NOVATO
Mailing Address - State:CA
Mailing Address - Zip Code:94948-6102
Mailing Address - Country:US
Mailing Address - Phone:415-884-3418
Mailing Address - Fax:
Practice Address - Street 1:3700 CALIFORNIA ST
Practice Address - Street 2:SUITE G350
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118-1618
Practice Address - Country:US
Practice Address - Phone:415-600-2940
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-15
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFA959ZMedicare PIN
CAFA959XMedicare PIN
CAFA959TMedicare PIN
CAFA959VMedicare PIN
CAFA959YMedicare PIN
CAFA959WMedicare PIN
CAFA959SMedicare PIN
CAFA959QMedicare PIN
CAFA959RMedicare PIN
CAFA959UMedicare PIN