Provider Demographics
NPI:1669691127
Name:CITY & COUNTY OF SAN FRANCISCO - DEPARTMENT OF PUBLIC HEALTH
Entity type:Organization
Organization Name:CITY & COUNTY OF SAN FRANCISCO - DEPARTMENT OF PUBLIC HEALTH
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DEPARTMENT OF PUBLIC HEALTH - COMPL
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 1:1309 EVANS AVENUE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94124-1705
Mailing Address - Country:US
Mailing Address - Phone:415-206-7600
Mailing Address - Fax:
Practice Address - Street 1:1309 EVANS AVENUE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94124-1705
Practice Address - Country:US
Practice Address - Phone:415-206-7600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CITY & COUNTY OF SAN FRANCISCO - DEPARTMENT OF PUBLIC HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-04-24
Last Update Date:2011-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)