Provider Demographics
NPI:1639526775
Name:UC HASTINGS STUDENT HEALTH SERVICES
Entity Type:Organization
Organization Name:UC HASTINGS STUDENT HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:
Authorized Official - Last Name:BROOKNER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:415-581-8813
Mailing Address - Street 1:100 MCALLISTER ST
Mailing Address - Street 2:ROOM 202
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-4929
Mailing Address - Country:US
Mailing Address - Phone:415-565-4612
Mailing Address - Fax:415-565-4607
Practice Address - Street 1:200 MCALLISTER ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-4707
Practice Address - Country:US
Practice Address - Phone:415-565-4612
Practice Address - Fax:415-565-4607
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UC HASTINGS COLLEGE OF THE LAW
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-05-18
Last Update Date:2016-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service