1861681868 NPI number — CATHOLIC CHARITIES CYO OF THE ARCHDIOCESE OF SAN FRANCISCO

Table of content: (NPI 1861681868)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861681868 NPI number — CATHOLIC CHARITIES CYO OF THE ARCHDIOCESE OF SAN FRANCISCO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CATHOLIC CHARITIES CYO OF THE ARCHDIOCESE 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:
SAN FRANCISCO BOYS' & GIRLS' HOME
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:
1861681868
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/01/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
11/23/2021
NPI Reactivation Date:
06/01/2022

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1555 39TH AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN FRANCISCO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94122-3015
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
415-972-1211
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
750 33RD AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN FRANCISCO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94121-3428
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
415-668-0190
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/16/2007

Additional Information

Authorized Official

Authorized Official Last Name:
MCCARTHY
Authorized Official First Name:
COLLEEN
Authorized Official Middle Name:
BABETTE
Authorized Official Title or Position:
DIR. OF CONTRACTS & GRANTS
Authorized Official Telephone Number:
415-972-1211

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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