San Quentin

LBN: San Quentin
San Quentin is an health care organization with primary practice located at 1635 Josephine St , Berkeley CA 94703-1320. The organization recently has only one registered license in Agencies / Case Management, which is considered as the primary health care specialty. San Quentin can be contacted via phone (415) 454-1469, or through Roach, Christopher via phone (415) 454-1460.

Contact Information

Primary practice address
1635 Josephine St Berkeley CA 94703-1320
Phone: (415) 454-1469
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Roach, Christopher PSYCH. D
Phone: (415) 454-1460

Health care specialties

SpecialtyCodeLicense #State
Agencies / Case Management 251B00000X

Profile Details

NPI number 1710329925
LBN Legal business name San Quentin
DBA Doing business as
Authorized official Roach, Christopher PSYCH. D
Entity Organization
Organization subpart 1 No
Enumeration date Jul 29th, 2013
Last updated Jul 29th, 2013 - about 11 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710329925 NPPES
California Other LCS14462 LCSW

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