Provider Demographics
NPI:1366512493
Name:YOUNG MEN'S CHRISTIAN ASSOCIATION OF SAN FRANCISCO
Entity type:Organization
Organization Name:YOUNG MEN'S CHRISTIAN ASSOCIATION OF SAN FRANCISCO
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JANE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHANDLER
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:415-561-0631
Mailing Address - Street 1:1530 BUCHANAN ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-3709
Mailing Address - Country:US
Mailing Address - Phone:707-861-0595
Mailing Address - Fax:415-863-8017
Practice Address - Street 1:1530 BUCHANAN ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-3709
Practice Address - Country:US
Practice Address - Phone:707-861-0595
Practice Address - Fax:415-563-8017
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106H00000X251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0000038BVMedicaid