Healthcare Provider Details

I. General information

NPI: 1174448351
Provider Name (Legal Business Name): JOSEPH PATRICK FENECH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1360 OAKDALE AVE
SAN FRANCISCO CA
94124-2724
US

IV. Provider business mailing address

1360 OAKDALE AVE
SAN FRANCISCO CA
94124-2724
US

V. Phone/Fax

Practice location:
  • Phone: 415-330-1540
  • Fax:
Mailing address:
  • Phone: 415-330-1540
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number120889
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: