Healthcare Provider Details

I. General information

NPI: 1891361218
Provider Name (Legal Business Name): S AND F GROUP HOLDINGS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2021
Last Update Date: 09/06/2021
Certification Date: 09/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2615 CAMINO DEL RIO S STE 201
SAN DIEGO CA
92108-3713
US

IV. Provider business mailing address

2615 CAMINO DEL RIO S STE 201
SAN DIEGO CA
92108-3713
US

V. Phone/Fax

Practice location:
  • Phone: 619-436-1622
  • Fax: 619-436-1664
Mailing address:
  • Phone: 619-436-1622
  • Fax: 619-436-1664

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: DR. JASON SHOEMAKER
Title or Position: COO
Credential: PHD
Phone: 310-795-4066