Union Street Health Assoc Inc

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY11092 Issued in CA

Legal business name

UNION STREET HEALTH ASSOC INC

Practice address

2084 Union Street
San Francisco, CA 94123

Phone

(415) 931-3819

Fax

(415) 563-2457

NPI assigned

Oct 13, 2006

Organization subpart

No

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

Authorized official

Name

Ilene Ana Serlin, PHD

Title

President

Phone

(415) 931-3819

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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

• Daniel L. Gaylinn, M.A., PH.D.

  • Psychologist
  • San Francisco, CA
  • NPI 1396977302
  NPD (past)
• Lori Rifkin, PHD

  • Clinical Psychologist
  • San Rafael, CA
  • NPI 1518012541
  NPD (past)

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1881784858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2084 UNION STREET",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "94123",
            "telephone_number": "415-931-3819",
            "fax_number": "415-563-2457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2084 UNION STREET",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "94123",
            "telephone_number": "415-931-3819",
            "fax_number": "415-563-2457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNION STREET HEALTH ASSOC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SERLIN",
        "authorized_official_first_name": "ILENE",
        "authorized_official_middle_name": "ANA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "415-931-3819",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY11092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Psychologist in California

• 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.