Organization
KAISER PERMANENTE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. VIRGINIA PIETERS (PROVIDER ENROLLMENT ANALST)
(415) 444-3522
Entity
Organization
Contact information
Practice address
111 SMITH RANCH ROAD, KAISER PERMANENTE, SAN RAFAEL, CA 94903
(415) 444-3522
(415) 491-3028
Mailing address
111 SMITH RANCH ROAD, KAISER PERMANENTE, SAN RAFAEL, CA 94903
(415) 444-3522
(415) 491-3028
Taxonomy
Speciality
Code
Description
License number
State
273R00000X
Psychiatric Hospital Unit
Primary
LCS14720
CA
Other
Enumeration date
01/09/2015
Last updated
01/09/2015
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