Healthcare Provider Details

I. General information

NPI: 1205983269
Provider Name (Legal Business Name): IRIS CENTER: WOMEN'S COUNSELING AND RECOVERY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2007
Last Update Date: 04/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 GOUGH ST FIRST FLOOR
SAN FRANCISCO CA
94103-1290
US

IV. Provider business mailing address

12 GOUGH ST FIRST FLOOR
SAN FRANCISCO CA
94103-1290
US

V. Phone/Fax

Practice location:
  • Phone: 415-864-2364
  • Fax: 415-864-0116
Mailing address:
  • Phone: 415-864-2364
  • Fax: 415-864-0116

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name: MRS. JULIA E SCHINDLER
Title or Position: FINANCIAL DEPT ADMINISTRATIVE ASST
Credential:
Phone: 415-864-2364