1366993198 NPI number — SAN FRANCISCO NEUROPSYCHOLOGY PC

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 1366993198 NPI number — SAN FRANCISCO NEUROPSYCHOLOGY PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SAN FRANCISCO NEUROPSYCHOLOGY PC
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 NEUROPSYCHOLOGY PC
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:
1366993198
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/07/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
833 MARKET ST
Provider Second Line Business Mailing Address:
SUITE 809
Provider Business Mailing Address City Name:
SAN FRANCISCO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94103-1814
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
415-627-9095
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
833 MARKET ST
Provider Second Line Business Practice Location Address:
SUITE 809
Provider Business Practice Location Address City Name:
SAN FRANCISCO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94103-1814
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
415-627-9095
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/17/2016

Additional Information

Authorized Official

Authorized Official Last Name:
TOLEDO
Authorized Official First Name:
GINA
Authorized Official Middle Name:
NICHOLE
Authorized Official Title or Position:
PRACTICE MANAGER
Authorized Official Telephone Number:
415-672-9095

Provider Taxonomy Codes

  • Taxonomy code: 103G00000X , with the licence number:  PSY28386 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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