| Telecare-adult Full Service Partnership | |
|
1692 El Camino Real San Carlos CA 94070-5208 | |
| (650) 817-9070 | |
| (650) 817-9074 |
| Full Name | Telecare-adult Full Service Partnership |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1692 El Camino Real, San Carlos, California |
| Authorized Official Name and Position | Leslie Davis (SVP, CFO) |
| Authorized Official Contact | 5103377950 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Telecare-adult Full Service Partnership 1080 Marina Village Pkwy Suite 100 Alameda CA 94501-1078 Ph: (510) 337-7950 | Telecare-adult Full Service Partnership 1692 El Camino Real San Carlos CA 94070-5208 Ph: (650) 817-9070 |
| NPI Number | 1598833733 |
|---|---|
| Provider Enumeration Date | 12/04/2006 |
| Last Update Date | 07/14/2020 |
| Certification Date | 07/14/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598833733 | NPI | - | NPPES |
| CR722E | Other | CA | MEDICARE PTAN |
| 41BA | Other | CA | COUNTY MENTAL HEATLH CERTIFICATE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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Starvista Girls Program Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 335 Quarry Rd, San Carlos, CA 94070 Phone: 650-591-6323 Fax: 650-591-3600 | |
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