Provider Demographics
NPI:1407003312
Name:SANEMATSU, DEAN
Entity type:Individual
Prefix:
First Name:DEAN
Middle Name:
Last Name:SANEMATSU
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1385 MISSION ST
Mailing Address - Street 2:200
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-2623
Mailing Address - Country:US
Mailing Address - Phone:415-864-7833
Mailing Address - Fax:415-864-7093
Practice Address - Street 1:1385 MISSION ST STE 240
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-2631
Practice Address - Country:US
Practice Address - Phone:415-864-7833
Practice Address - Fax:415-864-7093
Is Sole Proprietor?:No
Enumeration Date:2008-08-21
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X, 373H00000X, 225400000X
CAS1104291427101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist