Healthcare Provider Details

I. General information

NPI: 1174875512
Provider Name (Legal Business Name): UCSF STUDENT HEALTH AND COUNSELING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2012
Last Update Date: 06/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 PARNASSUS AVE MILLBERRY UNION, LEVEL P8, ROOM 005
SAN FRANCISCO CA
94143-0722
US

IV. Provider business mailing address

500 PARNASSUS AVE MILLBERRY UNION, LEVEL P8, ROOM 005
SAN FRANCISCO CA
94143-0722
US

V. Phone/Fax

Practice location:
  • Phone: 415-476-1281
  • Fax: 415-476-6137
Mailing address:
  • Phone: 415-476-1281
  • Fax: 415-476-6137

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS1000X
TaxonomyStudent Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. CHAITALI MUKHERJEE
Title or Position: EXECUTIVE DIRECTOR
Credential: MD, MPH
Phone: 415-476-1683