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General NPI Number Information
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NPI Number | 1679402846
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Entity Type | Organization
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Legal Business Name | HEADSPACE MEDICAL GROUP MI PLLC
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Dates
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Enumeration Date | 05/14/2026
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Last Update Date | 05/14/2026
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Provider Practice Location Address
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Address Line | 595 MARKET ST FL 7
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City | SAN FRANCISCO
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State | CA
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Zip | 94105-2802
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Country | US
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Telephone | 832-235-4476
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Fax |
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Provider Business Mailing Address
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Address Line | 595 MARKET ST FL 7
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City | SAN FRANCISCO
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State | CA
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Zip | 94105-2802
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SENIOR DIRECTOR, RCM AND PAYER OPS
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Name | SOPHIE XU
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Credential |
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Telephone | 832-235-4476
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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