Provider Demographics
NPI:1457742835
Name:SIDE BY SIDE
Entity type:Organization
Organization Name:SIDE BY SIDE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:415-457-3200
Mailing Address - Street 1:810 5TH AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94901-3252
Mailing Address - Country:US
Mailing Address - Phone:415-870-9298
Mailing Address - Fax:415-785-3283
Practice Address - Street 1:810 5TH AVE STE 100
Practice Address - Street 2:
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94901-3252
Practice Address - Country:US
Practice Address - Phone:415-870-9298
Practice Address - Fax:415-785-3283
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-06
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health