Theresa Ick

Primary specialty

SpecialistTaxonomy code 174400000X

Practice address

1380 Howard St FL 4
San Francisco, CA 94103-2651

Phone

(628) 217-6421

NPI assigned

Dec 26, 2013

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1388016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598227200000",
    "number": "1033530613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 VAN NESS AVE",
            "address_2": "SUITE 500",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941026033",
            "telephone_number": "415-437-6247",
            "fax_number": "415-431-0353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1380 HOWARD ST FL 4",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941032651",
            "telephone_number": "628-217-6421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ICK",
        "first_name": "THERESA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-26",
        "last_updated": "2020-08-24",
        "certification_date": "2020-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1744R1102X",
            "taxonomy_group": "",
            "desc": "Specialist, Research Study",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yasmien Ibrahim, PHARMD
• Zaki Ibrahim
• Hosna Ibrahimi
• Morgan Ichimoto
• Nancy Yoshiy Ichiuji, PHARM.D.
• Cindy Fae Icke, L.AC., O.M.D.
• Ida Gorshteyn, DDS, Ms, Inc.
• Ida Vandaei Licensed Clinical Social Worker Corporation
• Aimebenomon Omoye Idahosa, MD
• Kijafa Idalliah

• Specialist in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.