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General NPI Number Information
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NPI Number | 1174858146
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Entity Type | Organization
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Legal Business Name | YOUR EMOTIONAL SAFETYNET
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Dates
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Enumeration Date | 10/08/2009
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Last Update Date | 10/08/2009
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Provider Practice Location Address
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Address Line | 1980 OLIVERA RD STE D
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City | CONCORD
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State | CA
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Zip | 94520-5454
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Country | US
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Telephone | 800-511-7119
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Fax | 510-588-4046
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Provider Business Mailing Address
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Address Line | 1980 OLIVERA RD STE D
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City | CONCORD
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State | CA
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Zip | 94520-5454
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Country | US
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Telephone | 800-511-7119
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Fax | 510-588-4046
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. ANN KATHRYN MULVILLE MCFARLAND
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Credential | LCSW
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Telephone | 800-511-7119
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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 | LCS 21650
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License Number State | CA
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