Healthcare Provider Details

I. General information

NPI: 1568750891
Provider Name (Legal Business Name): LATINO COMMISSION ON ALCOHOL AND DRUG ABUSE SERVICES OF SAN MATEO COUN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2011
Last Update Date: 08/12/2024
Certification Date: 08/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 SNEATH LN STE 307
SAN BRUNO CA
94066-2349
US

IV. Provider business mailing address

1001 SNEATH LN STE 307
SAN BRUNO CA
94066-2349
US

V. Phone/Fax

Practice location:
  • Phone: 650-244-1444
  • Fax: 650-244-1447
Mailing address:
  • Phone: 650-244-1444
  • Fax: 650-244-1447

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code405300000X
TaxonomyPrevention Professional
License Number
License Number State

VIII. Authorized Official

Name: MS. DEBRA CAMARILLO
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 650-244-1444