| NPI | 1780356626 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUDITH CHEROTICH LEITICH Nurse Practitioner 415-200-7070 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| 363LP2300X Nurse Practitioner, Primary Care | |
| Enumeration Date | 2021-09-29 |
| Last Update Date | 2024-04-26 |