Healthcare Provider Details

I. General information

NPI: 1174933949
Provider Name (Legal Business Name): CONARD HOUSE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2014
Last Update Date: 05/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1385 MISSION ST SUITE 200
SAN FRANCISCO CA
94103-2623
US

IV. Provider business mailing address

42 WASHBURN ST
SAN FRANCISCO CA
94103-2663
US

V. Phone/Fax

Practice location:
  • Phone: 415-864-4002
  • Fax: 415-864-2231
Mailing address:
  • Phone: 415-864-8701
  • Fax: 415-864-0682

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: TSEDALE ZENEBE
Title or Position: PROGRAM DIRECTOR
Credential:
Phone: 415-864-8701