Provider Demographics
NPI:1730237470
Name:ROBERTSON, VERONICA D (NP)
Entity type:Individual
Prefix:MS
First Name:VERONICA
Middle Name:D
Last Name:ROBERTSON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:446 RANDOLPH ST
Mailing Address - Street 2:HIP HOP CLINIC
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94132-3122
Mailing Address - Country:US
Mailing Address - Phone:415-337-4719
Mailing Address - Fax:415-337-4719
Practice Address - Street 1:446 RANDOLPH ST
Practice Address - Street 2:HIP HOP CLINIC
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94132-3122
Practice Address - Country:US
Practice Address - Phone:415-337-4719
Practice Address - Fax:415-337-4719
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN385016163WC1500X
CANPF5344363LC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
Not Answered363LC1500XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
052084OtherSFGH INTERNAL USE ONLY-COMMERCIAL NUMBER
052084OtherSFGH INTERNAL USE ONLY-COMMERCIAL NUMBER