Provider Demographics
NPI:1881185221
Name:CITY & COUNTY OF SAN FRANCISCO
Entity Type:Organization
Organization Name:CITY & COUNTY OF SAN FRANCISCO
Other - Org Name:TREATMENT ACCESS PROGRAM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COMPLIANCE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CHONA
Authorized Official - Middle Name:G
Authorized Official - Last Name:BAUTISTA-PERALTA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:415-255-3706
Mailing Address - Street 1:1380 HOWARD ST FL 1
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-2638
Mailing Address - Country:US
Mailing Address - Phone:415-503-4748
Mailing Address - Fax:415-255-3629
Practice Address - Street 1:1380 HOWARD ST FL 1
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-2638
Practice Address - Country:US
Practice Address - Phone:415-503-4748
Practice Address - Fax:415-255-3629
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CITY & COUNTY OF SAN FRANCISCO
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-05-22
Last Update Date:2018-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251S00000X
251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health