Healthcare Provider Details
I. General information
NPI: 1871426858
Provider Name (Legal Business Name): MISSION NEIGHBORHOOD RESOURCE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
165 CAPP ST
SAN FRANCISCO CA
94110-1209
US
IV. Provider business mailing address
165 CAPP ST
SAN FRANCISCO CA
94110-1209
US
V. Phone/Fax
- Phone: 415-869-7977
- Fax: 415-241-9758
- Phone: 415-869-7977
- Fax: 415-241-9758
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171M00000X |
| Taxonomy | Case Manager/Care Coordinator |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MARVIN
WILFREDO
ROMERO
Title or Position: CARE MANAGER
Credential: ECM
Phone: 415-869-7977