Provider Demographics
NPI:1255681300
Name:HOMELESS CHILDREN'S NETWORK
Entity Type:Organization
Organization Name:HOMELESS CHILDREN'S NETWORK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SUPERVISOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LYORA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZUDIT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-437-3990
Mailing Address - Street 1:3265 17TH ST STE 404
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-1259
Mailing Address - Country:US
Mailing Address - Phone:415-437-3990
Mailing Address - Fax:415-437-3994
Practice Address - Street 1:3265 17TH ST STE 404
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-1259
Practice Address - Country:US
Practice Address - Phone:415-437-3990
Practice Address - Fax:415-437-3994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-17
Last Update Date:2012-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty