Healthcare Provider Details

I. General information

NPI: 1992011977
Provider Name (Legal Business Name): CITYWIDE CASE MANAGEMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2010
Last Update Date: 08/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

982 MISSION ST FL 2
SAN FRANCISCO CA
94103-2911
US

IV. Provider business mailing address

982 MISSION ST FL 2
SAN FRANCISCO CA
94103-2911
US

V. Phone/Fax

Practice location:
  • Phone: 415-597-8069
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number101YM0800X
License Number StateCA

VIII. Authorized Official

Name: MS. SARAH NIGHSWANDER
Title or Position: INTERN
Credential:
Phone: 510-334-6262