Tides Center

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

Legal business name

TIDES CENTER

Practice address

1008 General Kennedy Ave
Suite R
San Francisco, CA 94129-1729

Phone

(415) 236-1166

NPI assigned

Aug 19, 2013

Organization subpart

Yes

Parent organization

TIDES CENTERAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Sarah Rodriguez'G, M.S.

Title

Executive Director

Phone

(415) 236-1166

Specialties & licenses 1

Addresses

Other names 1

• Adolescent Health Working Group Other name

Tax ID family

Tides Centerinic4 organizations share this tax ID, including this one

Part of

Tides Centerinic

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

• Tides Center

  • Exclusive Provider Organization
  • San Francisco, CA
  • NPI 1083940969
  NPD tax ID
• Tides Centerinic

  • Clinic/Center
  • San Francisco, CA
  • NPI 1093709206
  NPD tax ID
• Youth Justice Institute

  • Point of Service
  • San Francisco, CA
  • NPI 1518293927
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1376870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481846400000",
    "number": "1003249657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1008 GENERAL KENNEDY AVE",
            "address_2": "SUITE R",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941291729",
            "telephone_number": "415-236-1166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1008 GENERAL KENNEDY AVE",
            "address_2": "SUITE R",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941291729",
            "telephone_number": "415-236-1166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIDES CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TIDES CENTER",
        "enumeration_date": "2013-08-19",
        "last_updated": "2016-12-16",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ'G",
        "authorized_official_first_name": "SARAH",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "415-236-1166",
        "authorized_official_credential": "M.S."
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Adolescent Health Working Group",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Victoria Tichenor, PH.D.
• Samuel Isaac Tick-Raker
• Iesha Ticknor
• Matthew Tidd, LCSW
• Justine Tideman, PSY.D.
• Tides Center
• Tides Centerinic
• Roy Tidwell
• Irene Elena Tiedeman, RN
• Ivy Tiegel, LMFT, MA, MFA

• Exclusive Provider Organization in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Exclusive Provider Organization in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.