NPIMap

Organization Active NPI

Individual Application

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • San Francisco, CA
National Provider Identifier
1356792204
Registry record updated Jun 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
INDIVIDUAL APPLICATION
Practice address
86 Peralta Ave
San Francisco, CA 94110-4841
Phone
(530) 276-1952
NPI assigned
Jun 22, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2016

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

Authorized official

Name
Megan BrubakerNPI 1154772234
Title
MFT Intern
Phone
(530) 276-1952

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

86 Peralta Ave
San Francisco, CA 94110-4841

Mailing address

86 Peralta Ave
San Francisco, CA 94110-4841

National Provider Directory

National Provider Directory
Tax ID family
Spartanburg Regional72 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 1

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

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1466553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466553600000",
    "number": "1356792204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "86 PERALTA AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941104841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "86 PERALTA AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941104841",
            "telephone_number": "530-276-1952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIVIDUAL APPLICATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-22",
        "last_updated": "2016-06-22",
        "status": "A",
        "authorized_official_last_name": "BRUBAKER",
        "authorized_official_first_name": "MEGAN",
        "authorized_official_title_or_position": "MFT INTERN",
        "authorized_official_telephone_number": "530-276-1952"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jun 22, 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.