Provider Demographics
NPI:1336983220
Name:MOUNT ST. JOSEPH-ST. ELIZABETH
Entity type:Organization
Organization Name:MOUNT ST. JOSEPH-ST. ELIZABETH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SISTER
Authorized Official - Middle Name:BETTY MARIE
Authorized Official - Last Name:DUNKEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-351-4045
Mailing Address - Street 1:100 MASONIC AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94118-4415
Mailing Address - Country:US
Mailing Address - Phone:415-567-8370
Mailing Address - Fax:
Practice Address - Street 1:242 BALBOA ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118-3905
Practice Address - Country:US
Practice Address - Phone:415-567-8370
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MOUNT ST. JOSEPH-ST. ELIZABETH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-06-24
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health