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General NPI Number Information
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NPI Number | 1316101421
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Entity Type | Organization
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Legal Business Name | DEPT. VETERANS AFFAIRS
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Dates
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Enumeration Date | 07/17/2008
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Last Update Date | 07/17/2008
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Provider Practice Location Address
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Address Line | 401 3RD ST
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City | SAN FRANCISCO
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State | CA
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Zip | 94107-1214
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Country | US
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Telephone | 415-551-7334
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Fax |
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Provider Business Mailing Address
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Address Line | 401 3RD ST
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City | SAN FRANCISCO
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State | CA
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Zip | 94107-1214
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Country | US
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Telephone | 415-551-7334
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Fax |
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Authorized Official
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Title or Position | CHIEF OF NURSING SERVICE
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Name | GLORIA MARTINEZ
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Credential | DNS, RN
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Telephone | 415-221-4810
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | 352646
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License Number State | CA
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