Provider Demographics
NPI:1689941981
Name:DPH CHILD CRISIS
Entity Type:Organization
Organization Name:DPH CHILD CRISIS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HW II
Authorized Official - Prefix:
Authorized Official - First Name:HAYDEE
Authorized Official - Middle Name:
Authorized Official - Last Name:RUIZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-970-3927
Mailing Address - Street 1:3804 MISSION ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-5832
Mailing Address - Country:US
Mailing Address - Phone:415-970-3927
Mailing Address - Fax:
Practice Address - Street 1:3804 MISSION ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-5832
Practice Address - Country:US
Practice Address - Phone:415-970-3927
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-30
Last Update Date:2011-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health