Healthcare Provider Details

I. General information

NPI: 1710054200
Provider Name (Legal Business Name): UCSF
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

939 MARKET ST FL 4
SAN FRANCISCO CA
94103-1730
US

IV. Provider business mailing address

939 MARKET ST FL 4
SAN FRANCISCO CA
94103-1730
US

V. Phone/Fax

Practice location:
  • Phone: 415-597-8035
  • Fax: 415-597-8004
Mailing address:
  • Phone: 415-597-8035
  • Fax: 415-597-8004

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number00000000000
License Number StateCA

VIII. Authorized Official

Name: KA MAN CARMEN CHOW
Title or Position: SOCIAL WORK ASSOCIATE
Credential: MFT TRAINEE
Phone: 415-597-8035