Mary Johanna Ford
Individual provider Active NPI Family Nurse Practitioner · Larkspur, CA
NPI 1922599802 · NPPES record last updated May 25, 2018
Key facts
- NPI
- 1922599802
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 95004594 (CA)
- Practice address
- 17 E Sir Francis Drake Blvd
Larkspur, CA 94939-1727 - Phone
- (415) 526-5631
- NPI assigned
- May 25, 2018
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95004594 | CA | MD | Family Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 95004594 | CA | Yes |
Addresses
Primary practice location
17 E Sir Francis Drake Blvd
Larkspur, CA 94939-1727
Mailing address
17 E Sir Francis Drake Blvd
Larkspur, CA 94939-1727
Phone (415) 526-5631
Other providers in Larkspur, CA
- Melina Jocelyn Figueroa
- Robert Lawrence Fisher
- Five Branches Acupuncture Inc
- Bette Foley
- Grace Fong
- Mariana Forni
- Julie Freedman
- Marvin Alan Freid
- Alexander Gregory Frost
- Colette R. Fujimoto
All providers in Larkspur, CA · Family Nurse Practitioner in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 25, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.