Provider Demographics
NPI:1013254507
Name:FELTON INSTITUTE
Entity Type:Organization
Organization Name:FELTON INSTITUTE
Other - Org Name:FAMILY SERVICE AGENCY OF SAN FRANCISCO
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CHIEF FINANCIAL & OPERATIONS OFFICE
Authorized Official - Prefix:
Authorized Official - First Name:MARVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-474-7310
Mailing Address - Street 1:1390 MARKET ST APT 1621
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-5310
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1390 MARKET ST APT 1621
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-5310
Practice Address - Country:US
Practice Address - Phone:818-331-4053
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-03
Last Update Date:2020-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF68517252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency