NPIMap

Organization Active NPI

City & County of San Francisco

Doing business as Southeast Mission Geriatric Mental Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • San Francisco, CA
National Provider Identifier
1639272008
Registry record updated Aug 8, 2013
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
CITY & COUNTY OF SAN FRANCISCO
Doing business as
Southeast Mission Geriatric Mental Health
Practice address
3905 Mission St
San Francisco, CA 94112-1014
Phone
(415) 337-4722
Fax
(415) 337-2415
NPI assigned
Sep 7, 2006
Last updated
Aug 8, 2013By the provider in NPPES
Organization subpart
Yes
Parent organization
CITY & COUNTY OF SAN FRANCISCO-DEPARTMENT OF PUBLIC HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 8, 2013

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

Authorized official

Name
Chona G Bautista-Peralta, LCSWNPI 1336298231
Title
Compliance Officer
Phone
(415) 255-3443

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

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

Addresses

Primary practice location

3905 Mission St
San Francisco, CA 94112-1014

Mailing address

1380 Howard St
4TH Floor, Room 426B
San Francisco, CA 94103-2638
Phone (415) 255-3443

Other names 1

  • Southeast Mission Geriatric Mental Health Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050309000770 CA Part B Supplier - Clinic/Group Practice 1658280748 Receives reassigned benefits from 1,564 practitioners
42 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: San Francisco, CA

Other NPIs on the same Medicare enrollment 39

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 39

National Provider Directory

National Provider Directory
Tax ID family
City County of San Fran141 organizations share this tax ID, including this one
Part of
City County of San Fran

Organizations with this tax ID in the same state 24

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

View all 24

Practitioners & affiliated clinicians

Practitioners 29

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.

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375920000000",
    "number": "1639272008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1380 HOWARD ST",
            "address_2": "4TH FLOOR, ROOM 426B",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941032638",
            "telephone_number": "415-255-3443",
            "fax_number": "415-252-3032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3905 MISSION ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941121014",
            "telephone_number": "415-337-4722",
            "fax_number": "415-337-2415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY & COUNTY OF SAN FRANCISCO",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CITY & COUNTY OF SAN FRANCISCO-DEPARTMENT OF PUBLIC HEALTH",
        "enumeration_date": "2006-09-07",
        "last_updated": "2013-08-08",
        "status": "A",
        "authorized_official_last_name": "BAUTISTA-PERALTA",
        "authorized_official_first_name": "CHONA",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "COMPLIANCE OFFICER",
        "authorized_official_telephone_number": "415-255-3443",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southeast Mission Geriatric Mental Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.