Healthcare Provider Details

I. General information

NPI: 1497875777
Provider Name (Legal Business Name): CITY & COUNTY OF SAN FRANCISCO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2007
Last Update Date: 02/21/2008
Certification Date:
Deactivation Date: 10/02/2007
Reactivation Date: 02/21/2008

III. Provider practice location address

1001 POTRERO AVENUE SAN FRANCISCO GENERAL HOSPITAL SA PROGAMS WARD 93
SAN FRANCISCO CA
94110-3518
US

IV. Provider business mailing address

1001 POTRERO AVE SFGH PSYCH ADMINISTRATION 7M17
SAN FRANCISCO CA
94110-3518
US

V. Phone/Fax

Practice location:
  • Phone: 415-206-6479
  • Fax: 415-206-8942
Mailing address:
  • Phone: 415-206-4550
  • Fax: 415-206-8942

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2800X
TaxonomyMethadone Clinic
License Number38-07
License Number StateCA

VIII. Authorized Official

Name: MS. SHARON MCCOLE WICHER
Title or Position: DIRECTOR BEHAVIORAL HEALTH
Credential: RN MS
Phone: 415-206-6569