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General NPI Number Information
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NPI Number | 1902286487
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Entity Type | Individual
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Provider Name | JAMES L FALLON CADAC II A044220517
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Gender | Male
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Dates
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Enumeration Date | 06/01/2015
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Last Update Date | 05/17/2018
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Provider Practice Location Address
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Address Line | 1563 MISSION ST
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City | SAN FRANCISCO
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State | CA
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Zip | 94103
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Country | US
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Telephone | 415-762-3700
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 14015
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City | SAN FRANCISCO
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State | CA
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Zip | 94114-0015
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Country | US
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Telephone | 415-516-1979
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Fax | 415-276-1962
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | RII02061214
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License Number State | CA
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