Provider Demographics
NPI:1699223628
Name:UCSF CHILDREN'S HOSPITAL
Entity Type:Organization
Organization Name:UCSF CHILDREN'S HOSPITAL
Other - Org Name:UCSF
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SENIOR DIETITIAN
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALLISON
Authorized Official - Middle Name:
Authorized Official - Last Name:LATRAY
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:916-216-6042
Mailing Address - Street 1:568 LOUIS DR
Mailing Address - Street 2:
Mailing Address - City:NOVATO
Mailing Address - State:CA
Mailing Address - Zip Code:94945-3337
Mailing Address - Country:US
Mailing Address - Phone:916-216-6042
Mailing Address - Fax:
Practice Address - Street 1:568 LOUIS DR
Practice Address - Street 2:
Practice Address - City:NOVATO
Practice Address - State:CA
Practice Address - Zip Code:94945-3337
Practice Address - Country:US
Practice Address - Phone:916-216-6042
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-19
Last Update Date:2016-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA963786282NC2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC2000XHospitalsGeneral Acute Care HospitalChildren