Provider Demographics
NPI:1851799266
Name:SAN MATEO COUNTY
Entity Type:Organization
Organization Name:SAN MATEO COUNTY
Other - Org Name:DAVID LEWIS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JEI
Authorized Official - Middle Name:
Authorized Official - Last Name:AFRICA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:650-613-2155
Mailing Address - Street 1:2277 UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:EAST PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94303-1717
Mailing Address - Country:US
Mailing Address - Phone:650-853-3139
Mailing Address - Fax:
Practice Address - Street 1:2277 UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:EAST PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94303-1717
Practice Address - Country:US
Practice Address - Phone:650-853-3139
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-17
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health