Provider Demographics
NPI:1356464879
Name:AGREGADO, JESUS F (PEER CASE MANAGER)
Entity Type:Individual
Prefix:
First Name:JESUS
Middle Name:F
Last Name:AGREGADO
Suffix:
Gender:M
Credentials:PEER CASE MANAGER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:760 HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94107-1235
Mailing Address - Country:US
Mailing Address - Phone:415-836-1700
Mailing Address - Fax:415-836-1737
Practice Address - Street 1:760 HARRISON ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94107-1235
Practice Address - Country:US
Practice Address - Phone:415-836-1700
Practice Address - Fax:415-836-1737
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
2923OtherCBHS INTERNAL USE ONLY-COMMERCIAL NUMBER
2923OtherSFGH INTERNAL USE ONLY