Provider Demographics
NPI:1366142655
Name:HABECK, SAMANTHA LOUIS (LE RN)
Entity type:Individual
Prefix:MS
First Name:SAMANTHA
Middle Name:LOUIS
Last Name:HABECK
Suffix:
Gender:F
Credentials:LE RN
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Mailing Address - Street 1:450 SUTTER ST RM 1010
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94108-3912
Mailing Address - Country:US
Mailing Address - Phone:415-780-1515
Mailing Address - Fax:415-398-7784
Practice Address - Street 1:450 SUTTER ST RM 1010
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94108-3912
Practice Address - Country:US
Practice Address - Phone:415-780-1515
Practice Address - Fax:415-398-7784
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-06
Last Update Date:2023-04-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CARN743292163WS0121X
CAL9780174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No163WS0121XNursing Service ProvidersRegistered NursePlastic Surgery