Healthcare Provider Details

I. General information

NPI: 1396896122
Provider Name (Legal Business Name): FELTON INSTITUTE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2007
Last Update Date: 11/30/2021
Certification Date: 11/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1663 MISSION ST STE 604
SAN FRANCISCO CA
94103-2473
US

IV. Provider business mailing address

1500 FRANKLIN ST
SAN FRANCISCO CA
94109-4523
US

V. Phone/Fax

Practice location:
  • Phone: 415-474-7310
  • Fax: 415-673-2488
Mailing address:
  • Phone: 415-518-9964
  • 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: MARVIN DAVIS
Title or Position: CHIEF FINANCIAL & OPERATIONS OFFICE
Credential:
Phone: 415-474-7310