Provider Demographics
NPI:1477004943
Name:FELTON INSTITUTE
Entity Type:Organization
Organization Name:FELTON INSTITUTE
Other - Org Name:DEAF COMMUNITY COUNSELING SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:PROGRAM MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:JONI
Authorized Official - Middle Name:
Authorized Official - Last Name:TEAGUELC
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:510-984-1654
Mailing Address - Street 1:1500 FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-4523
Mailing Address - Country:US
Mailing Address - Phone:415-474-7310
Mailing Address - Fax:415-447-9701
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:415-474-7310
Practice Address - Fax:415-447-9701
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FELTON INSTITUTE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-10-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPSB94021310OtherREGISTERED PSYCHOLOGICAL ASSISTANT