Provider Demographics
NPI:1366785669
Name:CHARPENTIER KERHERVE, CAROLINE SIMONE
Entity type:Individual
Prefix:MRS
First Name:CAROLINE
Middle Name:SIMONE
Last Name:CHARPENTIER KERHERVE
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 1:580 BANKS ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-6112
Mailing Address - Country:US
Mailing Address - Phone:415-867-6873
Mailing Address - Fax:
Practice Address - Street 1:580 BANKS ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-6112
Practice Address - Country:US
Practice Address - Phone:415-867-6873
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-04
Last Update Date:2013-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA374J00000X, 174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No174N00000XOther Service ProvidersLactation Consultant, Non-RN