Healthcare Provider Details

I. General information

NPI: 1528083300
Provider Name (Legal Business Name): CITY & COUNTY OF SAN FRANCISCO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 03/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

375 LAGUNA HONDA BLVD
SAN FRANCISCO CA
94116-1411
US

IV. Provider business mailing address

1001 POTRERO AVE BUILDING 20 WARD 24
SAN FRANCISCO CA
94110-3518
US

V. Phone/Fax

Practice location:
  • Phone: 415-759-3348
  • Fax: 415-759-3012
Mailing address:
  • Phone: 415-206-8338
  • Fax: 206-206-3837

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: THOMAS JOHN ISTVAN
Title or Position: PATIENT FINANCIAL DIRECTOR
Credential:
Phone: 415-206-4064