MEDICARE: HEALTHRIGHT 360

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number State
1	261QM0850X	Adult Mental Health Clinic/Center
2	261QM0855X	Adolescent and Children Mental Health Clinic/Center
3	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center
4	251S00000X	Community/Behavioral Health Agency	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1255409314
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTHRIGHT 360

Provider Business Mailing Address
First Line	:	1563 MISSION ST, 4TH FLOOR
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94103-2543
Country	:	US
Telephone Number	:	415-726-3700
Fax Number	:	415-865-0119

Provider Business Practice Location Address
First Line	:	1340 TULLY RD
Second Line	:	SUITE 301 & 304
City	:	SAN JOSE
State	:	CA
Zip	:	95122-3055
Country	:	US
Telephone Number	:	408-271-3900
Fax Number	:	408-271-3909

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	MS. VITKA EISEN
Credential	:
Telephone Number	:	415-762-1588

Provider Enumeration Date	:	11/30/2006
Last Update Date	:	08/19/2020

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Directions to “HEALTHRIGHT 360 ” Practice Location

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