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3150 18th St Ste 350 Mailbox #202 San Francisco CA 94110-2077 | |
| (415) 562-4156 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 3150 18th St Ste 350, San Francisco, California |
| Authorized Official Name and Position | Julio Lagos (PRESIDENT) |
| Authorized Official Contact | 4155624156 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
3150 18th St Ste 350 Mailbox #202 San Francisco CA 94110-2077 Ph: (415) 562-4156 | 3150 18th St Ste 350 Mailbox #202 San Francisco CA 94110-2077 Ph: (415) 562-4156 |
| NPI Number | 1437526209 |
|---|---|
| Provider Enumeration Date | 08/28/2015 |
| Last Update Date | 08/28/2015 |
| Medicare PECOS PAC ID | 0244549293 |
|---|---|
| Medicare Enrollment ID | O20151014002324 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437526209 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (California) | Secondary |
| 251S00000X | Community/behavioral Health | (California) | Primary |
| Provider Name | Julio C Lagos |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629106141 PECOS PAC ID: 3577884410 Enrollment ID: I20150604000819 |
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