| NPI | 1114704459 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BONNIE JEAN BARRETT Asa 415-473-6847 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2083P0901X Preventive Medicine Public Health & General Preventive Medicine |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 261QP2400X Clinic/Center Prison Health | |
| Enumeration Date | 2023-09-11 |
| Last Update Date | 2024-09-18 |