Basic Information
| Provider Information | |||||||||
| NPI: | 1891129748 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ANGUS | ||||||||
| FirstName: | LIANE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 153 COLLEGE AVE | ||||||||
| Address2: | |||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941121012 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 2222 BANCROFT WAY | ||||||||
| Address2: | UNIVERISITY HEALTH SERVICES, | ||||||||
| City: | BERKELEY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 947204301 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5106422000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/28/2013 | ||||||||
| LastUpdateDate: | 08/28/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 724907 | CA | Y | Nursing Service Providers | Registered Nurse |
No ID Information.