NPIMap

Organization Active NPI

Tides Centerinic

  • Clinic/Center
  • San Francisco, CA
National Provider Identifier
1093709206
Registry record updated Mar 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
TIDES CENTERINIC
Practice address
1833 Fillimore St
San Francisco, CA 94115
Phone
(415) 379-7800
Fax
(415) 379-7804
NPI assigned
Sep 1, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2013

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

Authorized official

Name
Carlina F. Hansen
Title
Executive Director
Phone
(415) 379-7800

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 220000401 CA
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

1833 Fillimore St
San Francisco, CA 94115

Mailing address

1833 Fillimore St
San Francisco, CA 94115
Phone (415) 379-7800

Other identifiers 1

IdentifierTypeStateIssuer
CMM70896FMedicaidCA

Other names 1

  • Women's Community Clinic Other name

National Provider Directory

National Provider Directory
Tax ID family
Tides Centerinic4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

1833 Fillmore St
San Francisco, CA 94115
Phone (415) 379-7800

NPI Registry JSON

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

{
    "created_epoch": "1125532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363046400000",
    "number": "1093709206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1833 FILLIMORE ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "94115",
            "telephone_number": "415-379-7800",
            "fax_number": "415-379-7804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1833 FILLIMORE ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "94115",
            "telephone_number": "415-379-7800",
            "fax_number": "415-379-7804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIDES CENTERINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-01",
        "last_updated": "2013-03-12",
        "status": "A",
        "authorized_official_last_name": "HANSEN",
        "authorized_official_first_name": "CARLINA",
        "authorized_official_middle_name": "F.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "415-379-7800"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "CA",
            "license": "220000401",
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CMM70896F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Women's Community Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2013; 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.