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General NPI Number Information
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NPI Number | 1841162211
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Entity Type | Organization
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Legal Business Name | PARENT SERVICES PROJECT
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Dates
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Enumeration Date | 09/23/2025
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Last Update Date | 09/23/2025
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Provider Practice Location Address
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Address Line | 79 BELVEDERE ST STE 101
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City | SAN RAFAEL
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State | CA
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Zip | 94901-4868
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Country | US
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Telephone | 415-454-1870
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Fax |
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Provider Business Mailing Address
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Address Line | 79 BELVEDERE ST STE 101
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City | SAN RAFAEL
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State | CA
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Zip | 94901-4868
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Country | US
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Telephone | 415-454-1870
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. BALANDRA FREGOSO
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Credential | LCSW
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Telephone | 415-497-7472
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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