NPIMap

Organization Active NPI

Latino Commission on Alcohol and Drug Abuse Services of San Mateo Coun

  • Substance Abuse Rehabilitation Facility
  • San Bruno, CA
National Provider Identifier
1417093105
Registry record updated Aug 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
LATINO COMMISSION ON ALCOHOL AND DRUG ABUSE SERVICES OF SAN MATEO COUN
Practice address
1001 Sneath LN Ste 210
San Bruno, CA 94066
Phone
(650) 244-1444
Fax
(650) 244-1447
NPI assigned
Jan 29, 2007
Last updated
Aug 12, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2024

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

Authorized official

Name
Ms. Debra CamarilloNPI 1851694913
Title
Executive Director
Phone
(650) 244-1444

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
Substance Abuse Rehabilitation Facility 324500000X Primary

Addresses

Primary practice location

1001 Sneath LN Ste 210
San Bruno, CA 94066

Mailing address

1001 Sneath LN Ste 307
San Bruno, CA 94066-2349
Phone (650) 244-1444

Other identifiers 1

IdentifierTypeStateIssuer
41491OtherCAOUTPATIENT PROGRAM

National Provider Directory

National Provider Directory
Tax ID family
Latino Commission on Alcohol and Drug Abuse Services of San Mateo Coun11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

Locations

1001 Sneath Ln
Ste 210
San Bruno, CA 94066
Phone (650) 871-8645

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723420800000",
    "number": "1417093105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 SNEATH LN STE 307",
            "city": "SAN BRUNO",
            "state": "CA",
            "postal_code": "940662349",
            "telephone_number": "650-244-1444",
            "fax_number": "650-244-1447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 SNEATH LN STE 210",
            "city": "SAN BRUNO",
            "state": "CA",
            "postal_code": "94066",
            "telephone_number": "650-244-1444",
            "fax_number": "650-244-1447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LATINO COMMISSION ON ALCOHOL AND DRUG ABUSE SERVICES OF SAN MATEO COUN",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-29",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A",
        "authorized_official_last_name": "CAMARILLO",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "650-244-1444",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OUTPATIENT PROGRAM",
            "identifier": "41491",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bruno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2024; 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.