Mina Vafaeezadeh

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

22564 Issued in CA

Practice address

505 Parnassus Ave
San Francisco, CA 94143-2204

Phone

(425) 241-4738

NPI assigned

Sep 5, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1409875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409875200000",
    "number": "1679974927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 PARK LAKE CIR APT C",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945985220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 PARNASSUS AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941432204",
            "telephone_number": "425-241-4738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAFAEEZADEH",
        "first_name": "MINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-05",
        "last_updated": "2014-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "22564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Margo Laine Vaclavek-Manalastas
• Ram Mohan C Vaderhobli, DDS, MS
• Vadim I Kvitash,MD,Inc.
• Vadim Skorupko DDS a Professional Corp
• Purnima Vadla
• Yasamin Vafai, MD, MS
• M Reza Vagefi, MD
• Anthony Vai
• Rajesh Roy Vaid, M.D.
• Vail Reese Union Square Dermatology

• Family Nurse Practitioner in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2014; 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.