Healthcare Provider Details

I. General information

NPI: 1992183578
Provider Name (Legal Business Name): HOMELESS CHILDREN'S NETWORK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2015
Last Update Date: 05/19/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3450 3RD ST
SAN FRANCISCO CA
94124-1443
US

IV. Provider business mailing address

1545 FLORIBUNDA AVE APT 201
BURLINGAME CA
94010-3869
US

V. Phone/Fax

Practice location:
  • Phone: 415-437-3990
  • Fax:
Mailing address:
  • Phone: 650-773-6576
  • Fax:

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: MISS ALEXANDRA NATASHA LAGRAN
Title or Position: STUDENT IN HEALTHCARE
Credential:
Phone: 415-437-3990