Provider Demographics
NPI:1285929034
Name:ALTERNATIVE FAMILY SERVICES
Entity type:Organization
Organization Name:ALTERNATIVE FAMILY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JAY
Authorized Official - Middle Name:
Authorized Official - Last Name:BERKIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-656-0116
Mailing Address - Street 1:1418 10TH AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94122-3662
Mailing Address - Country:US
Mailing Address - Phone:415-656-0116
Mailing Address - Fax:
Practice Address - Street 1:2500 EXECUTIVE PARK BOULEVARD
Practice Address - Street 2:
Practice Address - City:SAN FRANCSICO
Practice Address - State:CA
Practice Address - Zip Code:94134
Practice Address - Country:US
Practice Address - Phone:415-656-0116
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-09
Last Update Date:2011-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19268101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0000001DAOtherMEDICAL