Organization
IADET
Active
Organization
IADET
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CECILIA VELASCO (OFFICE MANAGER)
(415) 255-0371
Entity
Organization
Contact information
Practice address
3265 17TH ST STE 205, SAN FRANCISCO, CA 94110-1258
(415) 255-0371
Mailing address
2111 MISSION ST STE 205, SAN FRANCISCO, CA 94110-1274
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
3800404100
CA
Other
Enumeration date
08/09/2007
Last updated
08/09/2007
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