Provider Demographics
NPI:1598829160
Name:JEWISH FAMILY AND CHILDREN'S SERVICES
Entity Type:Organization
Organization Name:JEWISH FAMILY AND CHILDREN'S SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSOCIATE EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:GAYLE
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAHLER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:415-449-1286
Mailing Address - Street 1:1360 N DUTTON AVE STE C
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95401-4668
Mailing Address - Country:US
Mailing Address - Phone:707-303-1500
Mailing Address - Fax:707-571-8195
Practice Address - Street 1:1360 N DUTTON AVE STE C
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95401-4668
Practice Address - Country:US
Practice Address - Phone:707-303-1500
Practice Address - Fax:707-571-8195
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-20
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
CA=========Medicare UPIN
CAZZZ01132ZMedicare PIN