Healthcare Provider Details
I. General information
NPI: 1750998019
Provider Name (Legal Business Name): SONGBIRD HEALTH CA LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/29/2020
Last Update Date: 03/29/2022
Certification Date: 03/29/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
548 MARKET ST
SAN FRANCISCO CA
94104-5401
US
IV. Provider business mailing address
548 MARKET ST # 17739
SAN FRANCISCO CA
94104-5401
US
V. Phone/Fax
- Phone: 415-612-2337
- Fax: 209-336-0490
- Phone: 512-256-6855
- Fax: 209-336-0490
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
BENJAMIN
HSU
Title or Position: CO-FOUNDER
Credential:
Phone: 415-612-2337