Organization
HUCKLEBERRY YOUTH PROGRAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DOUGLAS STYLES PSYD (EXECUTIVE DIRECTOR)
(415) 668-2622
Entity
Organization
Contact information
Practice address
361 3RD ST STE G, SAN RAFAEL, CA 94901-3580
(415) 258-4944
(415) 258-4943
Mailing address
361 3RD ST STE G, SAN RAFAEL, CA 94901-3580
(415) 258-4944
(415) 258-4943
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
05/23/2012
Last updated
09/16/2022
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