Healthcare Provider Details

I. General information

NPI: 1609191675
Provider Name (Legal Business Name): YOUTH AND FAMILY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2010
Last Update Date: 06/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

408 TENNESSEE ST
VALLEJO CA
94590-4453
US

IV. Provider business mailing address

408 TENNESSEE ST
VALLEJO CA
94590-4453
US

V. Phone/Fax

Practice location:
  • Phone: 707-554-2397
  • Fax: 707-554-2397
Mailing address:
  • Phone: 707-554-2397
  • Fax: 707-554-2397

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MISS CAROL OSMER
Title or Position: SUPERVISOR
Credential: LCSW
Phone: 707-554-2397