MEDICARE: SENECA CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	322D00000X	Emotionally Disturbed Childrens' Residential Treatment Facility

General Provider Information

NPI Number	:	1326173568
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SENECA CENTER

Provider Business Mailing Address
First Line	:	887 POTRERO AVE
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94110-2869
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2701 IVY DR
Second Line	:	APT. C
City	:	OAKLAND
State	:	CA
Zip	:	94606-2172
Country	:	US
Telephone Number	:	510-316-4143
Fax Number	:

Authorized Official
Title or Position	:	PROGRAM DIRECTOR
Name	:	DANIELLE SIEGEL
Credential	:
Telephone Number	:	415-206-6388

Provider Enumeration Date	:	02/21/2007
Last Update Date	:	08/22/2020

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Directions to “SENECA CENTER ” Practice Location

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