Provider Demographics
NPI:1497875777
Name:CITY & COUNTY OF SAN FRANCISCO
Entity Type:Organization
Organization Name:CITY & COUNTY OF SAN FRANCISCO
Other - Org Name:DSAAM OTOP METHADONE DETOX
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR BEHAVIORAL HEALTH
Authorized Official - Prefix:MS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:MCCOLE
Authorized Official - Last Name:WICHER
Authorized Official - Suffix:
Authorized Official - Credentials:RN MS
Authorized Official - Phone:415-206-6569
Mailing Address - Street 1:1001 POTRERO AVE
Mailing Address - Street 2:SFGH PSYCH ADMINISTRATION 7M17
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-3518
Mailing Address - Country:US
Mailing Address - Phone:415-206-4550
Mailing Address - Fax:415-206-8942
Practice Address - Street 1:1001 POTRERO AVENUE
Practice Address - Street 2:SAN FRANCISCO GENERAL HOSPITAL SA PROGAMS WARD 93
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-3518
Practice Address - Country:US
Practice Address - Phone:415-206-6479
Practice Address - Fax:415-206-8942
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CITY AND COUNTY OF SAN FRANCISCO SF GENERAL HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-30
Last Update Date:2008-02-21
Deactivation Date:2007-10-02
Deactivation Code:
Reactivation Date:2008-02-21
Provider Licenses
StateLicense IDTaxonomies
CA38-07261QM2800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadone
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA3814OtherSHORT-DOYLE MEDICAL