Provider Demographics
NPI:1235339052
Name:CALIFORNIA PACIFIC MEDICAL CENTER
Entity Type:Organization
Organization Name:CALIFORNIA PACIFIC MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:GIRAURDO
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:415-600-6200
Mailing Address - Street 1:1625 VAN NESS AVE
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-3608
Mailing Address - Country:US
Mailing Address - Phone:415-600-6200
Mailing Address - Fax:415-749-1433
Practice Address - Street 1:1625 VAN NESS AVE
Practice Address - Street 2:3RD FLOOR
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-3608
Practice Address - Country:US
Practice Address - Phone:415-600-6200
Practice Address - Fax:415-749-1433
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-19
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT41112106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHSP40047GOtherMEDICAL