Healthcare Provider Details

I. General information

NPI: 1588536973
Provider Name (Legal Business Name): WESTSIDE COMMUNITY MENTAL HEALTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2025
Last Update Date: 09/23/2025
Certification Date: 09/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1018 MISSION ST
SAN FRANCISCO CA
94103-2813
US

IV. Provider business mailing address

1153 OAK ST
SAN FRANCISCO CA
94117-2216
US

V. Phone/Fax

Practice location:
  • Phone: 415-361-4950
  • Fax:
Mailing address:
  • Phone: 415-431-9000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: SHALECE BOOKER
Title or Position: CHIEF COMPLIANCE & OPERATING OFFICE
Credential:
Phone: 415-431-9000