Healthcare Provider Details

I. General information

NPI: 1669764148
Provider Name (Legal Business Name): COMPASS FAMILY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2011
Last Update Date: 05/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

49 POWELL ST 3RD FLOOR
SAN FRANCISCO CA
94102-2849
US

IV. Provider business mailing address

49 POWELL ST 3RD FLOOR
SAN FRANCISCO CA
94102-2849
US

V. Phone/Fax

Practice location:
  • Phone: 415-644-0504
  • Fax: 415-644-0514
Mailing address:
  • Phone: 415-644-0504
  • Fax: 415-644-0514

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MS. ERICA ANN KISCH
Title or Position: EXECUTIVE DIRECTOR
Credential: LCSW
Phone: 415-644-0504