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Organization

DIVISADERO HEALTH SERVICES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KIMBERLY NEWELL GREEN MD (PRESIDENT)
(415) 846-2891
Entity
Organization

Contact information

Practice address
2193 FILLMORE STREET, SAN FRANCISCO, CA 94115
(415) 496-5578
Mailing address
530 DIVISADERO ST STE 108, SAN FRANCISCO, CA 94117-2213
(415) 349-3901

Taxonomy

Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary

Other

Enumeration date
05/08/2023
Last updated
05/08/2023
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Product
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  • Eligibility checks
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