Healthcare Provider Details

I. General information

NPI: 1336983220
Provider Name (Legal Business Name): MOUNT ST. JOSEPH-ST. ELIZABETH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2024
Last Update Date: 06/24/2024
Certification Date: 06/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

242 BALBOA ST
SAN FRANCISCO CA
94118-3905
US

IV. Provider business mailing address

100 MASONIC AVE
SAN FRANCISCO CA
94118-4415
US

V. Phone/Fax

Practice location:
  • Phone: 415-567-8370
  • Fax:
Mailing address:
  • Phone: 415-567-8370
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: SISTER BETTY MARIE DUNKEL
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 415-351-4045