Healthcare Provider Details

I. General information

NPI: 1285970921
Provider Name (Legal Business Name): URBAN SERVICES YMCA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/28/2012
Last Update Date: 12/28/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1426 FILLMORE ST SUITE #204
SAN FRANCISCO CA
94115-5236
US

IV. Provider business mailing address

1426 FILLMORE ST SUITE #204
SAN FRANCISCO CA
94115-5236
US

V. Phone/Fax

Practice location:
  • Phone: 415-963-4149
  • Fax:
Mailing address:
  • Phone: 415-963-4149
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: JANE CHANDLER
Title or Position: CLINICAL DIRECTOR
Credential: M.A.,MFT
Phone: 415-963-4149