Provider Demographics
NPI:1437916020
Name:ULLOA, NELIDA CONCEPCION
Entity type:Individual
Prefix:
First Name:NELIDA
Middle Name:CONCEPCION
Last Name:ULLOA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:NELIDA
Other - Middle Name:CONCEPCION
Other - Last Name:ULLOA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:578 SAN JOSE AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-4410
Mailing Address - Country:US
Mailing Address - Phone:415-685-9945
Mailing Address - Fax:
Practice Address - Street 1:29 SAN JUAN AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94112-2615
Practice Address - Country:US
Practice Address - Phone:415-685-9945
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-01
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty