Provider Demographics
NPI:1174858146
Name:YOUR EMOTIONAL SAFETYNET
Entity Type:Organization
Organization Name:YOUR EMOTIONAL SAFETYNET
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:ANN
Authorized Official - Middle Name:KATHRYN MULVILLE
Authorized Official - Last Name:MCFARLAND
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:800-511-7119
Mailing Address - Street 1:1980 OLIVERA RD STE D
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94520-5454
Mailing Address - Country:US
Mailing Address - Phone:800-511-7119
Mailing Address - Fax:510-588-4046
Practice Address - Street 1:1980 OLIVERA RD STE D
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-5454
Practice Address - Country:US
Practice Address - Phone:800-511-7119
Practice Address - Fax:510-588-4046
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-08
Last Update Date:2009-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 21650251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health