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General NPI Number Information
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NPI Number | 1467509323
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Entity Type | Organization
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Legal Business Name | CENTER FOR OCCUPATIONAL PSYCHIATRY, INC.
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Dates
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Enumeration Date | 01/04/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1390 MARKET ST SUITE 301
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City | SAN FRANCISCO
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State | CA
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Zip | 94102-5402
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Country | US
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Telephone | 415-252-7878
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Fax | 415-701-7878
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Provider Business Mailing Address
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Address Line | 1390 MARKET ST SUITE 301
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City | SAN FRANCISCO
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State | CA
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Zip | 94102-5402
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Country | US
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Telephone | 415-252-7878
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Fax | 415-701-7878
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. ROBERT CHARLES LARSEN
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Credential | M.D., M.P.H.
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Telephone | 415-252-7878
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | FNP11266
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License Number State | CA
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