1508662719 NPI number — ELIZABETH MARSTON WHNP-BC

Table of content: ELIZABETH MARSTON WHNP-BC (NPI 1508662719)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1508662719 NPI number — ELIZABETH MARSTON WHNP-BC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MARSTON
Provider First Name:
ELIZABETH
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
WHNP-BC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1508662719
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/20/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1501 LINCOLN WAY APT 504
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN FRANCISCO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94122-1950
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
207-653-5001
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3 ALTARINDA RD STE 200
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ORINDA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94563-2601
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
925-254-9840
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/20/2025

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LW0102X , with the licence number:  95033734 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)