Provider Demographics
NPI:1295120855
Name:RUSSELL-SWETEK, AUBREY (CPNP)
Entity type:Individual
Prefix:
First Name:AUBREY
Middle Name:
Last Name:RUSSELL-SWETEK
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 16TH ST
Mailing Address - Street 2:4TH FLOOR, BOX 0434
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94158-2549
Mailing Address - Country:US
Mailing Address - Phone:415-514-0238
Mailing Address - Fax:415-353-2657
Practice Address - Street 1:1825 4TH ST
Practice Address - Street 2:6TH FLOOR
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94158-2350
Practice Address - Country:US
Practice Address - Phone:415-514-0238
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-31
Last Update Date:2015-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22141363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics