Healthcare Provider Details

I. General information

NPI: 1154739514
Provider Name (Legal Business Name): BAY AREA ADDICTION RESEARCH AND TREATMENT PROGRAMS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2014
Last Update Date: 07/31/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 MARKET ST
SAN FRANCISCO CA
94103-1513
US

IV. Provider business mailing address

1111 MARKET ST
SAN FRANCISCO CA
94103-1513
US

V. Phone/Fax

Practice location:
  • Phone: 415-863-3883
  • Fax:
Mailing address:
  • Phone: 415-863-3883
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name: JANEL WHEELER
Title or Position: PRACTICUM STUDENT
Credential:
Phone: 415-863-3883