NALLS FOUNDATION (NPI# 1134650070) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134650070 |
| Entity Type | Organization |
| Organization Name | NALLS FOUNDATION |
| Practice Address |
131 Persia Ave San Francisco CA 94112-2717 |
| Mailing Address |
Po Box 460338 San Francisco CA 94146-0338 |
| Practice Telephone | 4155861275 |
| Mailing Telephone | 4155861275 |
| Enumeration Date | 2017-03-22 |
| Last Update Date | 2017-03-23 |
| Authorized Official Name | TINA DOLLISON (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 4155056427 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | 385650019 | CA | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205367141 | Nalls Foundation | Community/Behavioral Health | 1261 Travis Blvd, Suite 240, Fairfield, CA 94533-4897 | 2017-03-22 |
| Street Address |
131 PERSIA AVE |
| City | SAN FRANCISCO |
| State | CA |
| Zip Code | 94112-2717 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396257473 | Yolanda Dollison | Counselor | 131 Persia Ave, San Francisco, CA 94112-2717 | 2017-10-30 |
| 1073025052 | Demetrius Dollison | Counselor | 131 Persia Ave, San Francisco, CA 94112-2717 | 2017-10-30 |
| 1386156685 | Fossestina Dollison | Counselor | 131 Persia Ave, San Francisco, CA 94112-2717 | 2017-10-26 |
| 1164933628 | Betty Obryant | Counselor | 131 Persia Ave, San Francisco, CA 94112-2717 | 2017-10-23 |
| 1386155844 | Richard Obryant | Counselor | 131 Persia Ave, San Francisco, CA 94112-2717 | 2017-10-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235737545 | Janine L Gong | Physical Therapist | 5737 Mission St., San Francisco, CA 94112 | 2020-10-09 |
| 1518449974 | Sophia Steffani | Behavioral Analyst | 385 Niagara Avenue, San Francisco, CA 94112 | 2018-09-02 |
| 1437642097 | Victoria Lopez | Registered Nurse | 1947 Center Street, 2nd Floor, Berkeley, CA 94112 | 2018-06-08 |
| 1962903773 | Joshua Jones | Behavior Technician | 795 Folsom St, 1st Floor, San Francisco, CA 94112 | 2018-02-27 |
| 1861917973 | Tiffany Huang | Occupational Therapist | 262 Broad Street, San Francisco, CA 94112 | 2017-08-09 |
| 1396113858 | David Laudenorio | Public Health or Welfare | 1221 Athens St, San Francisco, CA 94112 | 2015-09-14 |
| 1497133466 | Jennifer Michelle Zanoli | Student in an Organized Health Care Education/Training Program | 1701 Ocean Ave Omi Family Services, San Francisco, CA 94112 | 2015-05-11 |
| 1346653649 | Vincent Yan | Marriage & Family Therapist | 15 Robinson Dr, San Francisco, CA 94112 | 2014-06-04 |
| 1831448430 | Kelly Marie Thomas | Clinic/Center | 4877 Mission Street, San Francisco, CA 94112 | 2012-08-29 |
| 1467756544 | Andrew Loukas | Dentist | 5248 Mission St, San Francisco, CA 94112 | 2011-01-04 |
| Find all providers in zip 94112 | ||||
| Taxonomy Code | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
| Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568742823 | Edgewood Center | Residential Treatment Facility, Emotionally Disturbed Children | 1801 Vicente Ave, San Francisco, CA 94116 | 2011-08-18 |
| 1942469705 | Jory Daniel Linzer Zalona | Residential Treatment Facility, Emotionally Disturbed Children | 1814 Divisadero St, San Francisco, CA 94115-2517 | 2008-06-06 |
| 1093973679 | Amanda Marie Oswalt | Residential Treatment Facility, Emotionally Disturbed Children | 1062 Fulton St Apt 2, San Francisco, CA 94117-1627 | 2008-05-30 |
| 1043626617 | Samantha Mccants | Residential Treatment Facility, Emotionally Disturbed Children | 1801 Vicente St, San Francisco, CA 94116-2923 | 2014-07-03 |
| 1265865240 | Edgewood | Residential Treatment Facility, Emotionally Disturbed Children | 1801 Vicente St, San Francisco, CA 94116-2923 | 2013-08-14 |
| 1528386117 | Edge Wood | Residential Treatment Facility, Emotionally Disturbed Children | 1801 Vicente Street, San Francisco, CA 94116 | 2010-05-07 |
| 1235365883 | Noam Scott | Residential Treatment Facility, Emotionally Disturbed Children | 1801 Vicente St, San Francisco, CA 94116-2923 | 2009-06-09 |
| 1932341716 | Edgewood Center | Residential Treatment Facility, Emotionally Disturbed Children | 1801 Vicente St, San Francisco, CA 94116-2923 | 2009-03-25 |
| 1801056395 | Edgewood | Residential Treatment Facility, Emotionally Disturbed Children | 1801 Vicente St, San Francisco, CA 94116-2923 | 2008-06-10 |
| 1639340573 | Burt Childrens Center | Residential Treatment Facility, Emotionally Disturbed Children | 940 Grove St, San Francisco, CA 94117-1714 | 2008-03-19 |
| Find all providers in SAN FRANCISCO | ||||
| City | SAN FRANCISCO |
| Zip Code | 94112 |
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| 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.