Provider Demographics
NPI:1023524394
Name:HOWER, GRANT MADDUX
Entity type:Individual
Prefix:
First Name:GRANT
Middle Name:MADDUX
Last Name:HOWER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 410683
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94141-0683
Mailing Address - Country:US
Mailing Address - Phone:415-404-2124
Mailing Address - Fax:415-707-2100
Practice Address - Street 1:515 JOHN MUIR DR APT A519
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94132-1063
Practice Address - Country:US
Practice Address - Phone:415-747-4237
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-21
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA172V00000X
374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No172V00000XOther Service ProvidersCommunity Health Worker