1255440970 NPI number — CITY & COUNTY OF SAN FRANCISCO

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1255440970 NPI number — CITY & COUNTY OF SAN FRANCISCO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CITY & COUNTY OF SAN FRANCISCO
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
MISSION MENTAL HEALTH TEAM II OUTPATIENT SERVICES
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1255440970
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/13/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1380 HOWARD ST
Provider Second Line Business Mailing Address:
5TH FLOOR
Provider Business Mailing Address City Name:
SAN FRANCISCO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94103-2638
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
415-252-3056
Provider Business Mailing Address Fax Number:
415-252-3032

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3850 17TH ST.
Provider Second Line Business Practice Location Address:
SUITE 204
Provider Business Practice Location Address City Name:
SAN FRANCISCO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94114-2031
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
415-934-7700
Provider Business Practice Location Address Fax Number:
415-558-8221
Provider Enumeration Date:
08/29/2006

Additional Information

Authorized Official

Authorized Official Last Name:
LENROW
Authorized Official First Name:
LAURIE
Authorized Official Middle Name:
BETH
Authorized Official Title or Position:
MENTAL HEALTH MANAGER
Authorized Official Telephone Number:
415-934-7732

Provider Taxonomy Codes

  • Taxonomy code: 261QM0801X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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