Healthcare Provider Details
I. General information
NPI: 1437306594
Provider Name (Legal Business Name): HEALTHRIGHT 360
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/20/2008
Last Update Date: 12/31/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1340 TULLY RD SUITE 301
SAN JOSE CA
95122-3055
US
IV. Provider business mailing address
1735 MISSION ST
SAN FRANCISCO CA
94103-2417
US
V. Phone/Fax
- Phone: 408-271-3900
- Fax: 408-271-3909
- Phone: 415-726-3712
- Fax: 415-865-0119
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM0855X |
| Taxonomy | Adolescent and Children Mental Health Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
VITKA
EINSEN
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 415-726-1558