Healthcare Provider Details

I. General information

NPI: 1285406173
Provider Name (Legal Business Name): FAITH MANAIA TAUA I RADPT-I
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2023
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2261 BRYANT ST
SAN FRANCISCO CA
94110-2833
US

IV. Provider business mailing address

1563 MISSION ST
SAN FRANCISCO CA
94103-2543
US

V. Phone/Fax

Practice location:
  • Phone: 415-554-1450
  • Fax:
Mailing address:
  • Phone: 650-343-8401
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: