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403 W Orange Ave South San Francisco CA 94080-4443 | |
| (408) 971-9822 | |
| (408) 510-3484 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 403 W Orange Ave, South San Francisco, California |
| Authorized Official Name and Position | Andre Chapman (FOUNDER AND CEO) |
| Authorized Official Contact | 4085103480 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1400 Parkmoor Ave Ste 115 San Jose CA 95126-3797 Ph: (408) 971-9822 | 403 W Orange Ave South San Francisco CA 94080-4443 Ph: (408) 971-9822 |
| NPI Number | 1578053377 |
|---|---|
| Provider Enumeration Date | 05/16/2018 |
| Last Update Date | 05/16/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578053377 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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