Provider Demographics
NPI:1407970676
Name:SAN FRANCISCO COMMUNITY COLLEGE DISTRICT
Entity Type:Organization
Organization Name:SAN FRANCISCO COMMUNITY COLLEGE DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE CHANCELLOR OF ADMINISTRATION
Authorized Official - Prefix:MR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLDSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-241-2229
Mailing Address - Street 1:32 LYON ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94117-3024
Mailing Address - Country:US
Mailing Address - Phone:415-863-9517
Mailing Address - Fax:
Practice Address - Street 1:50 PHELAN AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94112-1821
Practice Address - Country:US
Practice Address - Phone:415-241-2229
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA196124261Q00000X, 261QA0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Not Answered261QA0005XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Family Planning Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA3399OtherNURSE PRACTITIONER CERTIF
CA196124OtherREGISTERED NURSE LICENSE