Healthcare Provider Details

I. General information

NPI: 1932459526
Provider Name (Legal Business Name): WESTSIDE COMMUNITY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2012
Last Update Date: 09/24/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 PIERCE ST
SAN FRANCISCO CA
94115
US

IV. Provider business mailing address

1301 PIERCE ST
SAN FRANCISCO CA
94115
US

V. Phone/Fax

Practice location:
  • Phone: 415-563-8200
  • Fax:
Mailing address:
  • Phone: 415-563-8200
  • Fax:

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: MARY ANN JONES
Title or Position: CEO
Credential: PH.D
Phone: 415-431-9000