Basic Information
| Provider Information | |||||||||
| NPI: | 1629158431 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CATHOLIC CHARITIES CYO OF THE ARCHDIOCESE OF SAN FRANCISCO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 990 EDDY ST | ||||||||
| Address2: | |||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941097713 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4159721200 | ||||||||
| FaxNumber: | 4159721201 | ||||||||
| Practice Location | |||||||||
| Address1: | 990 EDDY ST | ||||||||
| Address2: | |||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941097713 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4159721200 | ||||||||
| FaxNumber: | 4159721201 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/16/2006 | ||||||||
| LastUpdateDate: | 06/07/2019 | ||||||||
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| AuthorizedOfficialLastName: | KINAHAN | ||||||||
| AuthorizedOfficialFirstName: | JANET | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | CLINICAL SERVICES OFFICE MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 4155074213 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | Y | Agencies | Community/Behavioral Health |
No ID Information.