Provider Demographics
NPI:1346564150
Name:RANDALL, DAVID E
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:E
Last Name:RANDALL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6221 GEARY BLVD
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94121-1887
Mailing Address - Country:US
Mailing Address - Phone:415-386-6600
Mailing Address - Fax:415-751-3226
Practice Address - Street 1:1500 FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-4523
Practice Address - Country:US
Practice Address - Phone:415-386-6600
Practice Address - Fax:415-751-3226
Is Sole Proprietor?:No
Enumeration Date:2010-03-23
Last Update Date:2015-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst