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General NPI Number Information
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NPI Number | 1346564150
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Entity Type | Individual
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Provider Name | MR. DAVID E RANDALL
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Gender | Male
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Dates
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Enumeration Date | 03/23/2010
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Last Update Date | 12/21/2015
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Provider Practice Location Address
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Address Line | 1500 FRANKLIN ST
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City | SAN FRANCISCO
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State | CA
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Zip | 94109-4523
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Country | US
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Telephone | 415-386-6600
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Fax | 415-751-3226
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Provider Business Mailing Address
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Address Line | 6221 GEARY BLVD 2ND FLOOR
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City | SAN FRANCISCO
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State | CA
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Zip | 94121-1887
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Country | US
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Telephone | 415-386-6600
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Fax | 415-751-3226
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number |
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License Number State |
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