Healthcare Provider Details

I. General information

NPI: 1003431784
Provider Name (Legal Business Name): MEDENS HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2020
Last Update Date: 04/11/2023
Certification Date: 04/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 CALIFORNIA ST STE 1500
SAN FRANCISCO CA
94111-4612
US

IV. Provider business mailing address

2108 N ST STE 5619
SACRAMENTO CA
95816-5712
US

V. Phone/Fax

Practice location:
  • Phone: 415-854-5400
  • Fax: 844-654-2900
Mailing address:
  • Phone: 833-953-7400
  • Fax: 844-654-2900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: MEGHAN HORTON
Title or Position: CHIEF OF STAFF
Credential:
Phone: 415-854-5400