Provider Demographics
NPI:1629498118
Name:HEALTHRIGHT 360
Entity Type:Organization
Organization Name:HEALTHRIGHT 360
Other - Org Name:WOMEN COMMUNITY CLINIC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:VITKA
Authorized Official - Middle Name:
Authorized Official - Last Name:EISEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-762-3700
Mailing Address - Street 1:1563 MISSION STREET, 4TH FLOOR
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-2543
Mailing Address - Country:US
Mailing Address - Phone:415-762-3700
Mailing Address - Fax:415-379-7804
Practice Address - Street 1:1833 FILLMORE ST FL 3
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-3181
Practice Address - Country:US
Practice Address - Phone:415-379-7800
Practice Address - Fax:415-865-0119
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-23
Last Update Date:2018-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACMM70896FMedicaid