| Lyon-martin Community Health Services | |
|
1735 Mission St San Francisco CA 94103-2417 | |
| (415) 565-7667 | |
| (415) 252-7512 |
| Full Name | Lyon-martin Community Health Services |
|---|---|
| Speciality | Clinic/Center |
| Location | 1735 Mission St, San Francisco, California |
| Authorized Official Name and Position | Jackson James Miller Jaffe (CEO) |
| Authorized Official Contact | 4159017108 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lyon-martin Community Health Services 1735 Mission St San Francisco CA 94103-2417 Ph: (415) 565-7667 | Lyon-martin Community Health Services 1735 Mission St San Francisco CA 94103-2417 Ph: (415) 565-7667 |
| NPI Number | 1588238497 |
|---|---|
| Provider Enumeration Date | 05/14/2021 |
| Last Update Date | 05/14/2021 |
| Certification Date | 05/14/2021 |
| Medicare PECOS PAC ID | 6103203930 |
|---|---|
| Medicare Enrollment ID | O20220518000036 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588238497 | NPI | - | NPPES |
| Provider Name | Ryan N Gorton |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1124136650 PECOS PAC ID: 6608814041 Enrollment ID: I20050418000687 |
| Provider Name | Jessica L Wilson |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1992822316 PECOS PAC ID: 3476651035 Enrollment ID: I20140723001645 |
| Provider Name | Maisha A Davis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598150666 PECOS PAC ID: 3072827633 Enrollment ID: I20180911002668 |
| Provider Name | Mitzi Hawkins |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1477970515 PECOS PAC ID: 2567680358 Enrollment ID: I20180918003655 |
| Provider Name | Calvin Louis Gilbert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992228308 PECOS PAC ID: 4789920190 Enrollment ID: I20190107000555 |
| Provider Name | Sarah Ann Vela |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760848295 PECOS PAC ID: 2567884570 Enrollment ID: I20200622000197 |
| Provider Name | Pardis Esmaeili-firidouni |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1619514221 PECOS PAC ID: 0446676167 Enrollment ID: I20200812001735 |
| Provider Name | Ma Isabella Ventura |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366072894 PECOS PAC ID: 1153731096 Enrollment ID: I20201105000215 |
| Provider Name | Timothy Loyd Foster |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770880270 PECOS PAC ID: 1658784855 Enrollment ID: I20210107001350 |
| Provider Name | Alecia Lanette Greenlee |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1487072922 PECOS PAC ID: 4688977325 Enrollment ID: I20210304002115 |
| Provider Name | Aj Pluss |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1457822512 PECOS PAC ID: 8123426723 Enrollment ID: I20211012003455 |
| Provider Name | Raelynne Wiest |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720756992 PECOS PAC ID: 3375933005 Enrollment ID: I20211210001977 |
| Provider Name | Cicily R Cooper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518573161 PECOS PAC ID: 3274946553 Enrollment ID: I20220207001289 |
| Provider Name | Jamison Bradshaw |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1588026959 PECOS PAC ID: 7214222173 Enrollment ID: I20220804003090 |
| Provider Name | Zo Amaro Nadine Jimenez |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1245971027 PECOS PAC ID: 3072997444 Enrollment ID: I20220902000998 |
| Provider Name | Oneida Chi |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1568971778 PECOS PAC ID: 4880070689 Enrollment ID: I20221003000317 |
| Provider Name | Marion G Pellegrini |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780018259 PECOS PAC ID: 7810229572 Enrollment ID: I20230816002850 |
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