Healthcare Provider Details

I. General information

NPI: 1588163448
Provider Name (Legal Business Name): TRANSITION NETWORK GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2018
Last Update Date: 02/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2257 BUSH ST
SAN FRANCISCO CA
94115-3121
US

IV. Provider business mailing address

2443 FILLMORE ST STE 298
SAN FRANCISCO CA
94115-1814
US

V. Phone/Fax

Practice location:
  • Phone: 916-296-6564
  • Fax:
Mailing address:
  • Phone: 916-271-4634
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code405300000X
TaxonomyPrevention Professional
License Number
License Number State

VIII. Authorized Official

Name: MS. KAREN HAROLD
Title or Position: PRINCIPAL
Credential:
Phone: 916-271-4634