Healthcare Provider Details

I. General information

NPI: 1801959622
Provider Name (Legal Business Name): COMPREHENSIVE CHILD CRISIS SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3801 3RD ST SUITE 400
SAN FRANCISCO CA
94124-1409
US

IV. Provider business mailing address

3801 3RD ST SUITE 400
SAN FRANCISCO CA
94124-1409
US

V. Phone/Fax

Practice location:
  • Phone: 415-970-3844
  • Fax: 415-970-3855
Mailing address:
  • Phone: 415-970-3844
  • Fax: 415-970-3855

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number11503
License Number StateCA

VIII. Authorized Official

Name: MISS CUC (CORTNE) BUI
Title or Position: PSYCHIATRIC SOCIAL WORKER
Credential:
Phone: 415-970-3844