Provider Demographics
NPI:1891871950
Name:WESTSIDE CALWORKS
Entity Type:Organization
Organization Name:WESTSIDE CALWORKS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ABNER
Authorized Official - Middle Name:
Authorized Official - Last Name:BOLES
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:415-431-9000
Mailing Address - Street 1:1663 MISSION ST
Mailing Address - Street 2:STE 310
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-2400
Mailing Address - Country:US
Mailing Address - Phone:415-581-0449
Mailing Address - Fax:415-581-0458
Practice Address - Street 1:1663 MISSION ST
Practice Address - Street 2:STE 310
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-2400
Practice Address - Country:US
Practice Address - Phone:415-581-0449
Practice Address - Fax:415-581-0458
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW15208101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty