| San Jose Place | |
|
673 San Jose Ave San Francisco CA 94110-4914 | |
| (415) 282-3789 | |
| (415) 695-0829 |
| Full Name | San Jose Place |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 673 San Jose Ave, San Francisco, California |
| Authorized Official Name and Position | Brett Andrews (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 4159720806 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| San Jose Place 170 9th St San Francisco CA 94103-2603 Ph: (415) 305-5645 | San Jose Place 673 San Jose Ave San Francisco CA 94110-4914 Ph: (415) 282-3789 |
| NPI Number | 1720125925 |
|---|---|
| Provider Enumeration Date | 01/30/2007 |
| Last Update Date | 08/21/2021 |
| Certification Date | 08/21/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720125925 | NPI | - | NPPES |
| 01078907 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 385610012 (California) | Primary |
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