1497875777 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 1497875777 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:
Provider Other Organization Name Type Code:
6
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:
1497875777
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/21/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
10/02/2007
NPI Reactivation Date:
02/21/2008

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1001 POTRERO AVE
Provider Second Line Business Mailing Address:
SFGH PSYCH ADMINISTRATION 7M17
Provider Business Mailing Address City Name:
SAN FRANCISCO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94110-3518
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
415-206-4550
Provider Business Mailing Address Fax Number:
415-206-8942

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1001 POTRERO AVENUE
Provider Second Line Business Practice Location Address:
SAN FRANCISCO GENERAL HOSPITAL SA PROGAMS WARD 93
Provider Business Practice Location Address City Name:
SAN FRANCISCO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94110-3518
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
415-206-6479
Provider Business Practice Location Address Fax Number:
415-206-8942
Provider Enumeration Date:
03/30/2007

Additional Information

Authorized Official

Authorized Official Last Name:
WICHER
Authorized Official First Name:
SHARON
Authorized Official Middle Name:
MCCOLE
Authorized Official Title or Position:
DIRECTOR BEHAVIORAL HEALTH
Authorized Official Telephone Number:
415-206-6569

Provider Taxonomy Codes

  • Taxonomy code: 261QM2800X , with the licence number:  38-07 , 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)

  • Identifier: 3814 . This is a "SHORT-DOYLE MEDICAL" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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