Basic Information
Provider Information
NPI: 1528479318
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KIRSCH
FirstName: HANNAH
MiddleName: LOUISE
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 300 PASTEUR DR
Address2:  
City: STANFORD
State: CA
PostalCode: 943052200
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 300 PASTEUR DR
Address2:  
City: STANFORD
State: CA
PostalCode: 943052200
CountryCode: US
TelephoneNumber: 6464263876
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/14/2014
LastUpdateDate: 08/20/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/20/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084N0400X292471NYN Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
2084N0400XA141501CAY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology

No ID Information.


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