Basic Information
Provider Information
NPI: 1689784977
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HAAS-BECKERT
FirstName: BETSY
MiddleName:  
NamePrefix: MS.
NameSuffix:  
Credential: NP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1635 DIVISADERO ST
Address2: SUITE 625, BOX 1821
City: SAN FRANCISCO
State: CA
PostalCode: 941430001
CountryCode: US
TelephoneNumber: 4154764029
FaxNumber: 4154764150
Practice Location
Address1: 500 PARNASSUS MU 4TH FL E
Address2:  
City: SAN FRANCISCO
State: CA
PostalCode: 941430001
CountryCode: US
TelephoneNumber: 4154765892
FaxNumber: 4154761343
Other Information
ProviderEnumerationDate: 08/30/2006
LastUpdateDate: 07/09/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000X303036CAY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


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