Masonic Center for Youth and Families

Primary specialty

Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X

License

550001484 Issued in CA

Legal business name

MASONIC CENTER FOR YOUTH AND FAMILIES

Practice address

6 Funston Ave
San Francisco, CA 94129

Phone

(415) 929-3001

NPI assigned

Dec 9, 2014

Organization subpart

Yes

Parent organization

MASONIC HOMES OF CALIFORNIAAs reported in NPPES

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

Authorized official

Name

Susanna Bonetti

Title

Administrative Director

Phone

(415) 929-3001

Specialties & licenses 1

Addresses

Part of

Masonic Center for Youth and Families

Locations

Practitioners 3

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

• Elba Flores

  • Clinical Social Worker
  • Oakland, CA
  • NPI 1801102942
  NPD (past)
• Ethan Ornstein

  • Clinical Social Worker
  • San Francisco, CA
  • NPI 1316354434
  NPD (past)
• Kiernan Warble, LCSW

  • Mental Health Counselor
  • San Francisco, CA
  • NPI 1366849234
  NPD (past)

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

{
    "created_epoch": "1418083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418083200000",
    "number": "1356749279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 FUNSTON AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941291109",
            "telephone_number": "415-929-3001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 FUNSTON AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "94129",
            "telephone_number": "415-929-3001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MASONIC CENTER FOR YOUTH AND FAMILIES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MASONIC HOMES OF CALIFORNIA",
        "enumeration_date": "2014-12-09",
        "last_updated": "2014-12-09",
        "status": "A",
        "authorized_official_last_name": "BONETTI",
        "authorized_official_first_name": "SUSANNA",
        "authorized_official_title_or_position": "ADMINISTRATIVE DIRECTOR",
        "authorized_official_telephone_number": "415-929-3001"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "CA",
            "license": "550001484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paris Mason
• Rhys Levenson Mason, PSYD
• Sara Mason, PSYD
• Shayne Alan Mason, NP
• Timothy Mason, MSW
• Alyssa Mass, M.F.T.
• Martin Myron Mass, M.D.
• Shayna Lynae Massa, POSTPARTUM DOULA
• Stephen Mark Massa, M. D.
• Trace Richard Massa

• Adolescent and Children Mental Health Clinic/Center in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Adolescent and Children Mental Health Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2014; 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.