Provider Demographics
NPI:1346482114
Name:UNIVERSITY OF CALIFORNIA SAN FRANCISCO
Entity Type:Organization
Organization Name:UNIVERSITY OF CALIFORNIA SAN FRANCISCO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER II
Authorized Official - Prefix:
Authorized Official - First Name:KRISZTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:DIHEN
Authorized Official - Suffix:
Authorized Official - Credentials:MFTI
Authorized Official - Phone:415-730-1364
Mailing Address - Street 1:982 MISSION ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-2911
Mailing Address - Country:US
Mailing Address - Phone:415-730-1364
Mailing Address - Fax:415-597-8004
Practice Address - Street 1:982 MISSION ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-2911
Practice Address - Country:US
Practice Address - Phone:415-730-1364
Practice Address - Fax:415-597-8004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-25
Last Update Date:2009-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA50161251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management