Provider Demographics
NPI:1366191298
Name:NONPRASERT, WEERAPATTRA
Entity type:Individual
Prefix:MISS
First Name:WEERAPATTRA
Middle Name:
Last Name:NONPRASERT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1246 BUSH ST APT 4
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-5733
Mailing Address - Country:US
Mailing Address - Phone:415-340-9900
Mailing Address - Fax:
Practice Address - Street 1:1246 BUSH ST APT 4
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-5733
Practice Address - Country:US
Practice Address - Phone:415-340-9900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-18
Last Update Date:2022-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA88516225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1921202OtherAMTA INSURANCE