Healthcare Provider Details

I. General information

NPI: 1285841924
Provider Name (Legal Business Name): DAROLYN DENISE FOX CAADE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 PIERCE ST
SAN FRANCISCO CA
94115-4005
US

IV. Provider business mailing address

792 LYON ST
SAN FRANCISCO CA
94115-4316
US

V. Phone/Fax

Practice location:
  • Phone: 415-563-8200
  • Fax: 415-563-5985
Mailing address:
  • Phone: 415-567-4039
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number040985
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: