Provider Demographics
NPI:1609053180
Name:COMMUNITY YOUTH CENTER OF SAN FRANCISCO
Entity Type:Organization
Organization Name:COMMUNITY YOUTH CENTER OF SAN FRANCISCO
Other - Org Name:CYC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:CHING TING
Authorized Official - Last Name:WAN
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:415-775-2636
Mailing Address - Street 1:1038 POST ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-5603
Mailing Address - Country:US
Mailing Address - Phone:415-775-2636
Mailing Address - Fax:415-775-1345
Practice Address - Street 1:1038 POST ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-5603
Practice Address - Country:US
Practice Address - Phone:415-775-2636
Practice Address - Fax:415-775-1345
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-27
Last Update Date:2009-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health