Provider Demographics
NPI:1619454675
Name:PSYCHOLOGY SERVICES OF SAN FRANCISCO, INCORPORATED
Entity Type:Organization
Organization Name:PSYCHOLOGY SERVICES OF SAN FRANCISCO, INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HALE
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:415-548-1304
Mailing Address - Street 1:5758 GEARY BLVD # 626
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94121-2112
Mailing Address - Country:US
Mailing Address - Phone:415-548-1304
Mailing Address - Fax:866-339-6771
Practice Address - Street 1:582 MARKET ST STE 312
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94104-5304
Practice Address - Country:US
Practice Address - Phone:415-548-1304
Practice Address - Fax:866-339-6771
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-23
Last Update Date:2018-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY30044261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health