NPIMap

Organization Active NPI

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

  • Substance Abuse Rehabilitation Facility
  • San Francisco, CA
National Provider Identifier
1477699155
Registry record updated Aug 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
380055AN Issued in CA
Legal business name
LATINO COMMISSION ON ALCOHOL AND DRUG ABUSE SERVICES OF SAN MATEO COUN
Practice address
635 Brunswick St
San Francisco, CA 94112
Phone
(415) 337-4065
NPI assigned
Jan 29, 2007
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
Miss Debra Camarillo
Title
Executive Director
Phone
(650) 244-1442

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 380055AN CA Primary

Addresses

Primary practice location

635 Brunswick St
San Francisco, CA 94112

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
38472OtherCACASA QUETZAL

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.

Practitioners & affiliated clinicians

Practitioners 4

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": "1170028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723420800000",
    "number": "1477699155",
    "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": "635 BRUNSWICK ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "94112",
            "telephone_number": "415-337-4065"
        }
    ],
    "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": "650-244-1442",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": "380055AN",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CASA QUETZAL",
            "identifier": "38472",
            "state": "CA"
        }
    ],
    "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 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.