MEDICARE: BRIGHT PATH THERAPISTS

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	251C00000X	Developmentally Disabled Services Day Training Agency	1A-38-060	CA

General Provider Information

NPI Number	:	1548687288
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRIGHT PATH THERAPISTS

Provider Business Mailing Address
First Line	:	3444 21ST ST
Second Line	:	APT A
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94110-2213
Country	:	US
Telephone Number	:	415-689-1700
Fax Number	:	415-689-7333

Provider Business Practice Location Address
First Line	:	3444 21ST ST
Second Line	:	APT A
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94110-2213
Country	:	US
Telephone Number	:	415-689-1700
Fax Number	:	415-689-7333

Authorized Official
Title or Position	:	OWNER
Name	:	TONYA ZIMRING
Credential	:
Telephone Number	:	415-689-1700

Provider Enumeration Date	:	03/19/2014
Last Update Date	:	03/19/2014

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