Provider Demographics
NPI:1982771085
Name:CITY AND COUNTY OF SAN FRANCISCO
Entity Type:Organization
Organization Name:CITY AND COUNTY OF SAN FRANCISCO
Other - Org Name:CALIFORNIA CHILDREN'S SERVICES MEDICAL THERAPY UNIT
Other - Org Type:Other Name
Authorized Official - Title/Position:CHILDREN'S MEDICAL SERVICES DIRECTO
Authorized Official - Prefix:MS
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:L
Authorized Official - Last Name:WOLFE
Authorized Official - Suffix:
Authorized Official - Credentials:PNP, DR PH
Authorized Official - Phone:415-575-5712
Mailing Address - Street 1:101 GROVE ST
Mailing Address - Street 2:ROOM 110
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-4505
Mailing Address - Country:US
Mailing Address - Phone:415-554-2539
Mailing Address - Fax:415-554-2550
Practice Address - Street 1:1595 QUINTARA ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94116-1273
Practice Address - Country:US
Practice Address - Phone:415-759-2919
Practice Address - Fax:415-759-2898
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Single Specialty
Not Answered225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACCS00093FOtherMEDI-CAL