Organization
SAN MATEO COUNTY
Active
Other names
San Mateo Medical Center - Willow Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JUDITH DAVILA (AOD PROGRAM MANAGER)
(650) 802-5057
Entity
Organization
Contact information
Practice address
795 WILLOW RD, BLDG 332, MENLO PARK, CA 94025-2539
(650) 578-7190
Mailing address
400 HARBOR BLVD, BUILDING C, BELMONT, CA 94002-4047
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4191
PROVIDER NUMBER
CA
Enumeration date
01/16/2007
Last updated
08/22/2020
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