NPIMap

Organization Active NPI

University of California, San Francisco

  • Adolescent and Children Mental Health Clinic/Center
  • San Francisco, CA
National Provider Identifier
1174729065
Registry record updated May 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
Legal business name
UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
Practice address
995 Potrero Ave
BLDG 80, Ward 80, Basement Room 8000 S
San Francisco, CA 94110
Phone
(415) 206-8386
Fax
(415) 206-6273
NPI assigned
Jun 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 18, 2018

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

Authorized official

Name
Grace Fernandez
Title
Director, CPG Business Services
Phone
(415) 206-8969

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent and Children Mental Health Clinic/Center 261QM0855X CA Primary

Addresses

Primary practice location

995 Potrero Ave
BLDG 80, Ward 80, Basement Room 8000 S
San Francisco, CA 94110

Mailing address

PO Box 7464
San Francisco, CA 94120-7464
Phone (415) 502-7648

Other names 1

  • Department of Psychiatry, CASARC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090403000024 CA Part B Supplier - Clinic/Group Practice 3678547304 Receives reassigned benefits from 120 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: San Francisco, CA

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
UCSF Diaysis Medical52 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 20

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 20

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1182816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1526601600000",
    "number": "1174729065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7464",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941207464",
            "telephone_number": "415-502-7648",
            "fax_number": "415-502-8175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "995 POTRERO AVE",
            "address_2": "BLDG 80, WARD 80, BASEMENT ROOM 8000 S",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "94110",
            "telephone_number": "415-206-8386",
            "fax_number": "415-206-6273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF CALIFORNIA, SAN FRANCISCO",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-26",
        "last_updated": "2018-05-18",
        "status": "A",
        "authorized_official_last_name": "FERNANDEZ",
        "authorized_official_first_name": "GRACE",
        "authorized_official_title_or_position": "DIRECTOR, CPG BUSINESS SERVICES",
        "authorized_official_telephone_number": "415-206-8969"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Department of Psychiatry, CASARC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Department of Psychiatry, CASARC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 May 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.