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550 E Market St Daly City CA 94014-2103 | |
| (650) 243-4850 | |
| (650) 243-2851 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 550 E Market St, Daly City, California |
| Authorized Official Name and Position | Vitka Eisen (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 4157621558 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1735 Mission St San Francisco CA 94103-2417 Ph: (415) 762-3712 | 550 E Market St Daly City CA 94014-2103 Ph: (650) 243-4850 |
| NPI Number | 1942599238 |
|---|---|
| Provider Enumeration Date | 04/07/2011 |
| Last Update Date | 01/15/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942599238 | NPI | - | NPPES |
| 41CK | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
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