Healthcare Provider Details

I. General information

NPI: 1871256610
Provider Name (Legal Business Name): HOMELESS CHILDREN'S NETWORK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2021
Last Update Date: 10/19/2021
Certification Date: 10/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1426 FILLMORE ST STE 301
SAN FRANCISCO CA
94115-4164
US

IV. Provider business mailing address

1426 FILLMORE ST STE 301
SAN FRANCISCO CA
94115-4164
US

V. Phone/Fax

Practice location:
  • Phone: 415-651-7650
  • Fax:
Mailing address:
  • Phone: 415-651-7650
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: BONNIE LOUISE HARRISON
Title or Position: CLINICAL DIRECTOR
Credential: LCSW
Phone: 415-963-3549