NPIMap

Organization Active NPI

Catholic Charities Cyo

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • San Rafael, CA
National Provider Identifier
1710042650
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
Legal business name
CATHOLIC CHARITIES CYO
Practice address
1 Saint Vincents Dr
San Rafael, CA 94903-1504
Phone
(415) 507-2000
NPI assigned
Dec 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dawn Henson, LMFT
Title
Day Treatment Coordinator
Phone
(415) 507-4250

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X CA Primary

Addresses

Primary practice location

1 Saint Vincents Dr
San Rafael, CA 94903-1504

Mailing address

180 Howard St
Suite 100
San Francisco, CA 94105-1614
Phone (415) 972-1200

National Provider Directory

National Provider Directory
Tax ID family
St Vincents11 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

180 Howard St
Ste 100
San Francisco, CA 94105
Phone (415) 816-5031

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": "1166745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1710042650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 HOWARD ST",
            "address_2": "SUITE 100",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941051614",
            "telephone_number": "415-972-1200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SAINT VINCENTS DR",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949031504",
            "telephone_number": "415-507-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CATHOLIC CHARITIES CYO",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HENSON",
        "authorized_official_first_name": "DAWN",
        "authorized_official_title_or_position": "DAY TREATMENT COORDINATOR",
        "authorized_official_telephone_number": "415-507-4250",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Rafael, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.