# ST VINCENTS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1225327786
- **Authorized official:** ANGELA LOPEZ (FAMILY SPECIALIST)
- **Authorized official phone:** (415) 507-2000

## Contact information

- **Practice address:** 1 SAINT VINCENTS DR, SAN RAFAEL, CA 94903-1504
- **Practice address phone:** (415) 507-2000
- **Mailing address:** 154 IRIS RD, HERCULES, CA 94547-1215

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | — | — | Yes |

## Other

- **Enumeration date:** 04/05/2011
- **Last updated:** 04/05/2011