MEDICARE: FELTON INSTITUTE

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency	32200	CA

General Provider Information

NPI Number	:	1346636040
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FELTON INSTITUTE

Provider Business Mailing Address
First Line	:	1500 FRANKLIN ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94109-4523
Country	:	US
Telephone Number	:	415-474-7310
Fax Number	:

Provider Business Practice Location Address
First Line	:	14895 E 14TH ST
Second Line	:
City	:	SAN LEANDRO
State	:	CA
Zip	:	94578-2922
Country	:	US
Telephone Number	:	510-984-1654
Fax Number	:

Authorized Official
Title or Position	:	CHIEF FINANCIAL & OPERATIONS OFFICE
Name	:	MARVIN DAVIS
Credential	:
Telephone Number	:	415-474-7310

Provider Enumeration Date	:	04/09/2015
Last Update Date	:	02/14/2020

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Directions to “FELTON INSTITUTE ” Practice Location

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