Provider Demographics
NPI:1134319882
Name:UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
Entity Type:Organization
Organization Name:UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
Other - Org Name:CRISIS RESOLUTION TEAM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR, CPG BUSINESS SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:
Authorized Official - Last Name:FERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-206-8969
Mailing Address - Street 1:PO BOX 7464
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94120-7464
Mailing Address - Country:US
Mailing Address - Phone:415-502-7648
Mailing Address - Fax:415-502-8175
Practice Address - Street 1:1001 POTRERO AVE
Practice Address - Street 2:BLDG. 9 TRAILER
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-3518
Practice Address - Country:US
Practice Address - Phone:415-206-8426
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-30
Last Update Date:2007-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health