Provider Demographics
NPI:1063954741
Name:CITY CHURCH SAN FRANCISCO
Entity type:Organization
Organization Name:CITY CHURCH SAN FRANCISCO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELING CENTER DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOHNNY
Authorized Official - Middle Name:
Authorized Official - Last Name:LALONDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-346-6994
Mailing Address - Street 1:1388 SUTTER ST
Mailing Address - Street 2:SUITE 412
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-5427
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1388 SUTTER ST
Practice Address - Street 2:SUITE 412
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-5427
Practice Address - Country:US
Practice Address - Phone:415-346-6994
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-10
Last Update Date:2016-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health