MEDICARE: CATHOLIC CHARITIES CYO OF THE ARCHDIOCESE OF SAN FRANCISCO

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	251S00000X	Community/Behavioral Health Agency	385650001	CA

General Provider Information

NPI Number	:	1821280132
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CATHOLIC CHARITIES CYO OF THE ARCHDIOCESE OF SAN FRANCISCO

Provider Business Mailing Address
First Line	:	1555 39TH AVE
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94122-3015
Country	:	US
Telephone Number	:	415-972-1211
Fax Number	:

Provider Business Practice Location Address
First Line	:	823 EUCLID AVE
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94118-2510
Country	:	US
Telephone Number	:	415-221-3443
Fax Number	:	415-387-1627

Authorized Official
Title or Position	:	DIR OF CONTRACTS & GRANTS
Name	:	COLLEEN MCCARTHY
Credential	:
Telephone Number	:	415-972-1211

Provider Enumeration Date	:	08/10/2007
Last Update Date	:	04/12/2022

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