Organization
EDGEWOOD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CYNTHIA GREEN (DIRECTOR OF FAMILY CENTER)
(415) 375-7630
Entity
Organization
Contact information
Practice address
3801 3RD ST, SAN FRANCISCO, CA 94124-1409
(415) 375-7630
Mailing address
1801 VICENTE ST, SAN FRANCISCO, CA 94116-2923
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
172B00000X
MENTAL HEALTH ASSISTANT II
CA
Enumeration date
05/04/2015
Last updated
05/04/2015
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