| Buckelew Program | |
|
900 5th Ave San Rafael CA 94901-2959 | |
| (415) 457-6964 | |
| Not Available |
| Full Name | Buckelew Program |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 900 5th Ave, San Rafael, California |
| Authorized Official Name and Position | Katy Spense (SENIOR SITE MANAGER) |
| Authorized Official Contact | 4154576964 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Buckelew Program 900 5th Ave San Rafael CA 94901-2959 Ph: (415) 457-6964 | Buckelew Program 900 5th Ave San Rafael CA 94901-2959 Ph: (415) 457-6964 |
| NPI Number | 1649587874 |
|---|---|
| Provider Enumeration Date | 09/09/2010 |
| Last Update Date | 09/09/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649587874 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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