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General NPI Number Information
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NPI Number | 1093807315
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Entity Type | Organization
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Legal Business Name | SAN MATEO COUNTY
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Dates
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Enumeration Date | 09/28/2006
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Last Update Date | 06/05/2025
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Provider Practice Location Address
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Address Line | 1290 COMMODORE DR
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City | SAN BRUNO
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State | CA
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Zip | 94066-2304
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Country | US
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Telephone | 650-583-1260
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Fax |
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Provider Business Mailing Address
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Address Line | 1290 COMMODORE DR
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City | SAN BRUNO
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State | CA
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Zip | 94066-2304
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Country | US
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Telephone | 650-583-1260
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Fax |
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Authorized Official
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Title or Position | MENTAL HEALTH DIRECTOR
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Name | JEI AFRICA
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Credential |
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Telephone | 650-573-2748
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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