Provider Demographics
NPI:1447287917
Name:TIERNEY, MATTHEW JOSEPH (NP, MSN, RN)
Entity type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:JOSEPH
Last Name:TIERNEY
Suffix:
Gender:M
Credentials:NP, MSN, RN
Other - Prefix:
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Mailing Address - Street 1:239 ROOSEVELT WAY
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94114-1431
Mailing Address - Country:US
Mailing Address - Phone:415-552-5859
Mailing Address - Fax:
Practice Address - Street 1:1001 POTRERO AVE
Practice Address - Street 2:SAN FRANCISCO GENERAL HOSPITAL, DEPT. OF PSYCHIATRY
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-3518
Practice Address - Country:US
Practice Address - Phone:415-206-4310
Practice Address - Fax:415-206-6875
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CARN546728163WM0705X
CANPF11973363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
Not Answered363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health