Provider Demographics
NPI:1104403864
Name:HEALTH SERVICES FOUNDATION
Entity type:Organization
Organization Name:HEALTH SERVICES FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN/BOARD OF DIRECTORS
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:MUTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-639-9017
Mailing Address - Street 1:4160 DUBLIN BLVD STE 400
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:CA
Mailing Address - Zip Code:94568-7756
Mailing Address - Country:US
Mailing Address - Phone:925-321-6039
Mailing Address - Fax:
Practice Address - Street 1:16960 S HARLAN RD
Practice Address - Street 2:
Practice Address - City:LATHROP
Practice Address - State:CA
Practice Address - Zip Code:95330-8738
Practice Address - Country:US
Practice Address - Phone:800-284-3926
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-26
Last Update Date:2021-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164X00000XNursing Service ProvidersLicensed Vocational NurseGroup - Single Specialty