Healthcare Provider Details

I. General information

NPI: 1396120721
Provider Name (Legal Business Name): UCSF BENIOFF CHILDRENS HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2015
Last Update Date: 07/28/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1975 4TH ST 6TH FLOOR
SAN FRANCISCO CA
94158-2351
US

IV. Provider business mailing address

1975 4TH ST 6TH FLOOR
SAN FRANCISCO CA
94158-2351
US

V. Phone/Fax

Practice location:
  • Phone: 415-476-2188
  • Fax: 415-502-4867
Mailing address:
  • Phone: 415-476-2188
  • Fax: 415-502-4867

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC2000X
TaxonomyChildren's Hospital
License Number9510028
License Number StateCA

VIII. Authorized Official

Name: DIANE VONBEHREN
Title or Position: DIRECTOR OF PERINATAL SERVICES
Credential: RN
Phone: 415-353-1826