Provider Demographics
NPI:1134235559
Name:CITY & COUNTY OF SAN FRANCISCO
Entity type:Organization
Organization Name:CITY & COUNTY OF SAN FRANCISCO
Other - Org Name:<UNAVAIL>
Other - Org Type:
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:415-255-3443
Mailing Address - Street 1:1380 HOWARD STREET
Mailing Address - Street 2:4TH FLOOR ROOM 426 A
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-2638
Mailing Address - Country:US
Mailing Address - Phone:415-255-3706
Mailing Address - Fax:415-252-3032
Practice Address - Street 1:555 POLK STREET
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-3333
Practice Address - Country:US
Practice Address - Phone:415-202-2810
Practice Address - Fax:415-346-0483
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CITY & COUNTY OF SAN FRANCISCO-DEPARTMENT OF PUBLIC HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-21
Last Update Date:2012-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ88720ZMedicare UPIN