Provider Demographics
NPI:1891974515
Name:CITY & COUNTY OF SAN FRANCISCO
Entity Type:Organization
Organization Name:CITY & COUNTY OF SAN FRANCISCO
Other - Org Name:SAN FRANCISCO DEPARTMENT OF PUBLIC HEALTH
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DEPARTMENT OF PUBLIC HEALTH-COMPLIA
Authorized Official - Prefix:MRS
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:415-255-3443
Mailing Address - Street 1:101 GOUGH STREET
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102
Mailing Address - Country:US
Mailing Address - Phone:415-255-3400
Mailing Address - Fax:415-252-3032
Practice Address - Street 1:101 GOUGH ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-5903
Practice Address - Country:US
Practice Address - Phone:415-255-3400
Practice Address - Fax:415-252-3032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-30
Last Update Date:2013-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00000000Medicaid