MASONIC HOMES OF CALIFORNIA (NPI# 1043788953) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043788953 |
| Entity Type | Organization |
| Organization Name | MASONIC HOMES OF CALIFORNIA |
| Practice Address |
6 Funston Ave San Francisco CA 94129-1109 |
| Mailing Address |
1111 California St San Francisco CA 94108-2252 |
| Practice Telephone | 4152929166 |
| Mailing Telephone | 4152929166 |
| Enumeration Date | 2018-11-08 |
| Last Update Date | 2018-11-08 |
| Authorized Official Name | THOMAS BOYER (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 4152929166 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
Allopathic & Osteopathic Physicians | ||
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Masonic Center for Youth and Families | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639726102 | Masonic Homes of California | Skilled Nursing Facility | 161 S Reeder Ave, Covina, CA 91724-3129 | 2019-08-20 |
| 1295388106 | Masonic Homes of California | Community/Behavioral Health | 1650 E Old Badillo St, Covina, CA 91724-3163 | 2019-07-19 |
| 1578110524 | Masonic Homes of California | Assisted Living Facility | 1650 E Old Badillo St, Covina, CA 91724-3163 | 2019-08-23 |
| 1114111317 | Masonic Homes of California | Community/Behavioral Health | 34400 Mission Blvd, Union City, CA 94587-3604 | 2007-08-30 |
| 1043426588 | Masonic Homes of California | Nursing Facility/Intermediate Care Facility | 34400 Mission Blvd, Union City, CA 94587-3604 | 2007-05-14 |
| 1639134950 | Masonic Homes of California | Pharmacy | 34400 Mission Blvd, Union City, CA 94587-3604 | 2006-04-19 |
| 1942293071 | Masonic Homes of California | Pharmacy | 34400 Mission Blvd, Union City, CA 94587-3604 | 2005-08-24 |
| Street Address |
6 FUNSTON AVE |
| City | SAN FRANCISCO |
| State | CA |
| Zip Code | 94129-1109 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942578521 | Antonia Servat | Marriage & Family Therapist | 6 Funston Ave, San Francisco, CA 94129-1109 | 2011-12-09 |
| 1356749279 | Masonic Center for Youth and Families | Clinic/Center | 6 Funston Ave, San Francisco, CA 94129 | 2014-12-09 |
| 1366849234 | Kiernan Warble | Counselor | 6 Funston Ave, San Francisco, CA 94129-1109 | 2014-11-20 |
| 1083026504 | Shannon Jawahar Dodani | Psychologist | 6 Funston Ave, San Francisco, CA 94129-1109 | 2014-06-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801362652 | Jamin N Gorham | Physical Therapist | 1162 B Gorgas Avenue, San Francisco, CA 94129 | 2018-10-19 |
| 1942743307 | Kristin Elizabeth Goodrich | Physical Therapist | 1162 B Gorgas Ave, San Francisco, CA 94129 | 2016-12-02 |
| 1356822449 | Matthew Timothy Kuik | Physical Therapist | 1162 B Gorgas Ave, San Francisco, CA 94129 | 2018-08-27 |
| 1285286211 | Derek Wei-yun Wong | Behavior Technician | 1520 Pershing Dr Apt F, San Francisco, CA 94129-1096 | 2019-07-10 |
| 1841403052 | William Meehan | Psychologist | 10 Funston Avenue, The Presidio, San Francisco, CA 94129-1109 | 2007-05-07 |
| 1710017801 | Judith R Levin | Counselor | 10 Funston Ave, The Presidi, San Francisco, CA 94129-1109 | 2007-03-07 |
| 1174021182 | Gouverneur M Carnochan | Psychologist | 10 Funston Ave, San Francisco, CA 94129-1109 | 2018-01-24 |
| 1184095887 | Helga Fasching | Psychologist | 10 Funston Ave, San Francisco, CA 94129-1109 | 2015-10-07 |
| 1134489974 | Barbara Ivy Sharp | Psychologist | 10 Funston Ave, San Francisco, CA 94129-1109 | 2012-05-28 |
| 1457686545 | John Aloysius Sullivan | Psychologist | 10 Funston Ave, San Francisco, CA 94129-1109 | 2009-10-07 |
| Find all providers in zip 94129 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730792102 | Oladapo Tomori | Psychiatry & Neurology | Ginger, 116 New Montgomery Street, Suite 500, San Francisco, CA 94105 | 2020-08-26 |
| 1811524754 | Brightside Medical of New Jersey, P.C. | Psychiatry & Neurology | 156 2nd Street, San Francisco, CA 94105 | 2020-03-23 |
| 1841826211 | Richard Daniel Morgese | Psychiatry & Neurology | 98 Clarendon Ave, San Francisco, CA 94114-2102 | 2020-03-18 |
| 1356848436 | Ketamine Treatment Centers of California PC | Psychiatry & Neurology | 1700 California St Ste 450, San Francisco, CA 94109-4592 | 2018-04-06 |
| 1336648690 | Abilash Gopal Md PC | Psychiatry & Neurology | 2161 Union St Ste 3, San Francisco, CA 94123-4003 | 2018-02-01 |
| 1023542529 | Aneesh Nandam | Psychiatry & Neurology | 401 Parnassus Ave, Box-0984, San Francisco, CA 94143-0984 | 2017-04-12 |
| 1689107526 | Jennifer Lee | Psychiatry & Neurology | 401 Parnassus Avenue, Box-0984, San Francisco, CA 94143-0984 | 2017-04-07 |
| 1346772266 | Meitri Collaborative | Psychiatry & Neurology | 500 Sutter St Ste 503, San Francisco, CA 94102-1114 | 2017-03-30 |
| 1962859371 | Zhong Ye-bates | Psychiatry & Neurology | 801 Indiana St Unit 562, San Francisco, CA 94107-3660 | 2016-05-17 |
| 1114373370 | Daniel Peixoto Irby | Psychiatry & Neurology | 360 Post St Ste #500, San Francisco, CA 94108 | 2016-05-06 |
| Find all providers in SAN FRANCISCO | ||||
| City | SAN FRANCISCO |
| Zip Code | 94129 |
Please comment or provide details below to improve the information on MASONIC HOMES OF CALIFORNIA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.