Individual provider Active NPI

Hattie Clark Grundland, NP

  • Adult Health Nurse Practitioner
  • San Francisco, CA
National Provider Identifier
1760545297
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
14228 Issued in CA
Practice address
558 Clayton St
San Francisco, CA 94117-2907
Phone
(415) 487-5632
Fax
(415) 431-9909
NPI assigned
Dec 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 14228 CA Primary

Addresses

Primary practice location

558 Clayton St
San Francisco, CA 94117-2907

Mailing address

1420 18TH Ave
San Francisco, CA 94122-3409
Phone (415) 682-8339

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070730000230 CA Practitioner - Nurse Practitioner 3072614437 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
City & County of San Francisco Current Accepting new patients
City and County of San Francisco CurrentSince Feb 1, 2010 Accepting new patients
City & County of San Francisco CurrentSince Feb 1, 2010 Accepting new patients

Locations

1001 Potrero Ave
Bldg 20
San Francisco, CA 94110
Phone (415) 206-8524

1001 Potrero Ave
San Francisco, CA 94110
Phone (415) 206-2305

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1760545297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 18TH AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941223409",
            "telephone_number": "415-682-8339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "558 CLAYTON ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941172907",
            "telephone_number": "415-487-5632",
            "fax_number": "415-431-9909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUNDLAND",
        "first_name": "HATTIE",
        "middle_name": "CLARK",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "14228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.