Provider Demographics
NPI:1427171131
Name:CITY & COUNTY SAN FRANCISCO DEPARTMENT OF PUBLIC HEALTH
Entity type:Organization
Organization Name:CITY & COUNTY SAN FRANCISCO DEPARTMENT OF PUBLIC HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARC ELLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:GARTH
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:415-865-5255
Mailing Address - Street 1:1060 HOWARD ST
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-2820
Mailing Address - Country:US
Mailing Address - Phone:415-865-5255
Mailing Address - Fax:415-863-4867
Practice Address - Street 1:1060 HOWARD ST
Practice Address - Street 2:3RD FLOOR
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-2820
Practice Address - Country:US
Practice Address - Phone:415-865-5255
Practice Address - Fax:415-863-4867
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251K00000X
CAPSY18706251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered251K00000XAgenciesPublic Health or Welfare
Not Answered251S00000XAgenciesCommunity/Behavioral Health