VERICARE OF CALIFORNIA MEDICAL GROUP (NPI# 1164475299) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164475299 |
| Entity Type | Organization |
| Organization Name | VERICARE OF CALIFORNIA MEDICAL GROUP |
| Other Organization Name | VERICARE |
| Practice Address |
2707 Pine St San Francisco CA 94115-2522 |
| Mailing Address |
55 Hatchetts Hill Rd Old Lyme CT 06371-1534 |
| Practice Telephone | 8002578715 |
| Practice Fax Number | 8008191655 |
| Mailing Telephone | 8003703651 |
| Mailing Fax Number | 8775157147 |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2017-07-11 |
| NPI Deactivation Date | 04/11/2007 |
| NPI Reactivation Date | 2007-08-08 |
| Authorized Official Name | MELISSA KING (DIRECTOR, CREDENTIALING ENROLLMENT) |
| Authorized Official Telephone | 8003703651 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians | ||
| N | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 364SP0808X |
Clinical Nurse Specialist Specialization: Psych/Mental Health |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | RAILROAD MEDICARE | CC7816 | 01 |
| CA | GPS000150 | 05 |
| Other Name | Type Code |
|---|---|
| Vericare | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538114053 | Vericare of California Medical Group | Social Worker | 325 Kempton St, Spring Valley, CA 91977-5810 | 2006-05-23 |
| 1316992829 | Vericare of California Medical Group | Social Worker | 1633 Cypress Ln, Paradise, CA 95969-2823 | 2006-05-23 |
| 1275588790 | Vericare of California Medical Group | Social Worker | 1835 W La Veta Ave, Orange, CA 92868-4132 | 2006-05-23 |
| 1528011764 | Vericare of California Medical Group | Social Worker | 81 Professional Ctr Pkwy, San Rafael, CA 94903-2797 | 2006-05-18 |
| 1407047673 | Vericare of California Medical Group | Nurse Practitioner | 3293 N Drinkwater Blvd, Scottsdale, AZ 85251-6405 | 2007-08-05 |
| 1689629198 | Vericare of California Medical Group | Social Worker | 205 Granada St, Camarillo, CA 93010-7715 | 2006-05-23 |
| 1760437271 | Vericare of California Medical Group | Social Worker | 1505 Colby Dr, Glendale, CA 91205-3307 | 2006-05-23 |
| 1194779439 | Vericare of California Medical Group | Social Worker | 2501 Alvin Ave, San Jose, CA 95121-1660 | 2006-05-20 |
| 1104879980 | Vericare of California Medical Group | Social Worker | 2707 Pine St, San Francisco, CA 94115-2522 | 2006-05-19 |
| 1942254644 | Vericare of California Medical Group | Social Worker | 430 Willow St, Alameda, CA 94501-6130 | 2006-05-19 |
| Street Address |
2707 PINE ST |
| City | SAN FRANCISCO |
| State | CA |
| Zip Code | 94115-2522 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750909206 | Madeline Suzanne Smith | Physical Therapist | 2707 Pine St, San Francisco, CA 94115-2522 | 2020-07-10 |
| 1366082000 | Evan Garrett Copeland | Physical Therapy Assistant | 2707 Pine St, San Francisco, CA 94115-2522 | 2020-01-10 |
| 1255992467 | Alyssa Moore | Occupational Therapist | 2707 Pine St, San Francisco, CA 94115-2522 | 2019-06-27 |
| 1376103929 | Christina Derebenskaya | Speech-Language Pathologist | 2707 Pine St, San Francisco, CA 94115-2522 | 2019-06-17 |
| 1033777966 | Angela Hawthorne | Occupational Therapist | 2707 Pine St, San Francisco, CA 94115-2522 | 2019-06-05 |
| 1962067249 | Jennifer Wong | Occupational Therapist | 2707 Pine St, San Francisco, CA 94115-2522 | 2019-05-02 |
| 1457916843 | Joseph Matias Jr. | Physical Therapy Assistant | 2707 Pine St, San Francisco, CA 94115-2522 | 2019-05-01 |
| 1659834711 | Meredith Fritsch | Physical Medicine & Rehabilitation | 2707 Pine St, San Francisco, CA 94115-2522 | 2019-04-07 |
| 1083175129 | Katrina Smith | Occupational Therapy Assistant | 2707 Pine St, San Francisco, CA 94115-2522 | 2019-03-29 |
| 1487168712 | Amanda Chow | Physical Therapist | 2707 Pine St, San Francisco, CA 94115-2522 | 2017-11-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619593274 | Francene G Colvin | Psychologist | 1939 Divisadero, Suite 1, San Francisco, CA 94115 | 2020-06-19 |
| 1760015689 | Simon James Little | Psychiatry & Neurology | 1634 Divisadero St, Suite 250, San Francisco, CA 94115 | 2020-02-19 |
| 1881243822 | Clara Kwun | Social Worker | 1610 Scott St., San Francisco, CA 94115 | 2019-09-11 |
| 1467005207 | Tamara Aline Hostetler | Marriage & Family Therapist | 2859 Sacramento St., San Francisco, CA 94115 | 2019-07-22 |
| 1962054999 | Wendy Lynne Stern | Psychologist | 2104 Bush St., San Francisco, CA 94115 | 2019-07-10 |
| 1184188476 | Katherine Marie Carroll | Specialist/Technologist | 1731 B Buchanan Street, San Francisco, CA 94115 | 2019-01-30 |
| 1710467410 | Joanna Katherine Hendrick | Marriage & Family Therapist | 1201 Fillmore Street, San Francisco, CA 94115 | 2018-08-21 |
| 1063998771 | Leonard Cheung | Counselor | Youth Services Bureau of San Francisco, 1426 Fillmore Street Suite 216, San Francisco, CA 94115 | 2018-07-16 |
| 1942709563 | Jobelle Cunanan | Behavior Technician | 1871 Turk St, San Francisco, CA 94115 | 2018-02-09 |
| 1083128235 | Dr. Jenny Mann, Nd | Clinic/Center | 2300 Sutter St Ste 301, San Francisco, CA 94115 | 2017-11-27 |
| Find all providers in zip 94115 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689271785 | Michelle Sullivan | Psychologist | 2419 44th Ave, San Francisco, CA 94116-2062 | 2020-10-02 |
| 1295359438 | Robin Ruth | Psychologist | 2443 Fillmore St # 380-7876, San Francisco, CA 94115-1814 | 2020-06-03 |
| 1861020588 | Emma Salzman | Psychologist | 401 Parnassus Ave Rm 111, San Francisco, CA 94143-0984 | 2020-03-29 |
| 1992330518 | Dr. Nicole Mayeda, A Psychological Corporation | Psychologist | 22 Battery St., Suite 426, San Francisco, CA 94111-5542 | 2020-03-04 |
| 1699308726 | Kumar Therapy, A Psychological Corporation | Psychologist | 582 Market St Ste 1210, San Francisco, CA 94104-5313 | 2020-02-17 |
| 1619516010 | Zenobia New Grusky | Psychologist | 255 Jersey St, San Francisco, CA 94114-3822 | 2020-01-02 |
| 1629614144 | Larisa Beckwith | Psychologist | 764 Faxon Ave, San Francisco, CA 94112-1204 | 2019-11-19 |
| 1093360752 | Era A Loewenstein | Psychologist | 4317a 23rd St, San Francisco, CA 94114-3111 | 2019-08-08 |
| 1962054999 | Wendy Lynne Stern | Psychologist | 2104 Bush St., San Francisco, CA 94115 | 2019-07-10 |
| 1144881467 | Julie London | Psychologist | 2309 Noriega St # 302, San Francisco, CA 94122-4239 | 2019-06-26 |
| Find all providers in SAN FRANCISCO | ||||
| City | SAN FRANCISCO |
| Zip Code | 94115 |
Please comment or provide details below to improve the information on VERICARE OF CALIFORNIA MEDICAL GROUP.
| 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.