Benjamin Gordon Vaillancourt, RN, BSN
Registered Nurse in San Francisco, CA. Individual provider (NPI-1).
NPI number1669979902
StatusActive
Last updated in NPPESApr 12, 2018
Details
- NPI
- 1669979902
- Entity type
- Individual (NPI-1)
- Name
- Mr. Benjamin Gordon Vaillancourt
- Credential
- RN, BSN
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 12, 2018
- Last updated
- Apr 12, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 163W00000X | Registered Nurse | 813962 | CA | Yes |
Practice location
4150 Clement StSan Francisco, CA 94121-1563
Phone 510-701-5042
Mailing address
551 W Grand Ave Apt 20Oakland, CA 94612-1661
Phone 510-701-5042
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