Divisadero Health Services

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

Legal business name

DIVISADERO HEALTH SERVICES

Practice address

2193 Fillmore Street
San Francisco, CA 94115

Phone

(415) 496-5578

NPI assigned

May 8, 2023

Organization subpart

No

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

Authorized official

Name

Kimberly Newell Green, MDNPI 1952489593

Title

President

Phone

(415) 846-2891

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Kimberly L Newell Green, MD

  • Pediatrics Physician
  • San Francisco, CA
  • NPI 1952489593
  NPD Authorized official

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

{
    "created_epoch": "1683504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683504000000",
    "number": "1265121073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 DIVISADERO ST STE 108",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941172213",
            "telephone_number": "415-349-3901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2193 FILLMORE STREET",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "94115",
            "telephone_number": "415-496-5578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVISADERO HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-08",
        "last_updated": "2023-05-08",
        "certification_date": "2023-04-27",
        "status": "A",
        "authorized_official_last_name": "NEWELL GREEN",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "415-846-2891",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Ditzian
• Sushmitha Divakar
• Bethany Divakaran, RN PHN
• Divergent Worlds Psychotherapy and Consulting, Inc.
• Jennifer Divers, LMFT
• Divisadero Health Services of New Jersey, P.C.
• Devan Diwanji, MD, PHD
• Niharika Dixit, M.D
• Rakesh Kumar Dixit, M.D.
• Shalini Dixit

• Peer Specialist in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Peer Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2023; 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.