Provider Demographics
NPI:1881920148
Name:UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
Entity type:Organization
Organization Name:UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF ADMINISTRATION
Authorized Official - Prefix:
Authorized Official - First Name:JANE
Authorized Official - Middle Name:
Authorized Official - Last Name:CZECH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-476-3877
Mailing Address - Street 1:350 PARNASSUS AVE
Mailing Address - Street 2:SUITE 905
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94117-3608
Mailing Address - Country:US
Mailing Address - Phone:415-476-2912
Mailing Address - Fax:415-476-4800
Practice Address - Street 1:350 PARNASSUS AVE
Practice Address - Street 2:SUITE 905
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94117-3608
Practice Address - Country:US
Practice Address - Phone:415-476-2912
Practice Address - Fax:415-476-4800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-21
Last Update Date:2009-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP 17827235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty