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General NPI Number Information
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NPI Number | 1790151389
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Entity Type | Organization
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Legal Business Name | HOLOS INSTITUTE
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Dates
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Enumeration Date | 08/18/2015
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Last Update Date | 08/18/2015
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Provider Practice Location Address
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Address Line | 312 3RD AVE
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City | SAN FRANCISCO
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State | CA
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Zip | 94118-2403
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Country | US
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Telephone | 415-750-0478
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Fax |
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Provider Business Mailing Address
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Address Line | 312 3RD AVE
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City | SAN FRANCISCO
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State | CA
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Zip | 94118-2403
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Country | US
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Telephone | 415-750-0478
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | JAN EDL STEIN
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Credential | MFT
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Telephone | 415-751-1307
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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 | 25863
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License Number State | CA
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