SAN MATEO MEDICAL CENTER METHADONE TREATMENT PROGRAM (NPI# 1487872974) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487872974 |
| Entity Type | Organization |
| Organization Name | SAN MATEO MEDICAL CENTER METHADONE TREATMENT PROGRAM |
| Practice Address |
795 Willow Rd Building 332 Menlo Park CA 94025-2539 |
| Mailing Address |
222 W 39th Ave San Mateo CA 94403-4364 |
| Practice Telephone | 6505787190 |
| Mailing Telephone | 6505732222 |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DONNA DEAN (DIRECTOR) |
| Authorized Official Telephone | 6505787190 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM2800X |
Clinic/Center Specialization: Methadone Clinic |
4104 | CA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | HDC70098F | 05 |
| Street Address |
795 WILLOW RD BUILDING 332 |
| City | MENLO PARK |
| State | CA |
| Zip Code | 94025-2539 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205899168 | Vivian Chan | Nurse Practitioner | 795 Willow Rd, Menlo Park, CA 94025-2539 | 2006-04-10 |
| 1609481282 | Alyse Michele Gulack | Audiologist | 795 Willow Rd, Menlo Park, CA 94025-2539 | 2020-09-10 |
| 1114571213 | Suzanne Deisher | Art Therapist | 795 Willow Rd, Menlo Park, CA 94025-2539 | 2019-07-26 |
| 1003473984 | Timothy J Avery | Psychologist | 795 Willow Rd, Menlo Park, CA 94025-2539 | 2019-05-25 |
| 1093278483 | Jeane Bosch | Psychologist | 795 Willow Rd, Menlo Park, CA 94025-2539 | 2019-04-11 |
| 1417436122 | Erin Elena Martinez | Psychologist | 795 Willow Rd, Menlo Park, CA 94025-2539 | 2018-08-13 |
| 1619484961 | Tequila Webb | Social Worker | 795 Willow Rd, Menlo Park, CA 94025-2539 | 2018-01-09 |
| 1952815987 | Melinda Sue Ward | Social Worker | 795 Willow Rd, Menlo Park, CA 94025-2539 | 2017-11-29 |
| 1992218234 | Ashley Bauer | Psychologist | 795 Willow Rd, Menlo Park, CA 94025-2539 | 2017-11-08 |
| 1740790898 | Julia Mwangi | Pharmacist | 795 Willow Rd, Menlo Park, CA 94025-2539 | 2017-10-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396350112 | Grail, Inc. | Clinical Medical Laboratory | 1525 O'brien Drive, Menlo Park, CA 94025 | 2020-09-09 |
| 1528673399 | Hanan Wasse | Occupational Therapist | 860 Fremont # Apt 2, Menlo Park, CA 94025 | 2020-09-09 |
| 1356967608 | Raymond Joseph Brinkmann | Counselor | 795 Willow Road Bldg 332, Menlo Park, CA 94025 | 2020-06-23 |
| 1245859883 | Connie Margarita Alonzo-frisz | Marriage & Family Therapist | Garfield Community School, 3600 Middlefield Rd, Menlo Park, CA 94025 | 2020-04-14 |
| 1225661911 | Crossover Health Medical Group | Specialist | 193 Jefferson Dr., Menlo Park, CA 94025 | 2020-02-20 |
| 1942774732 | Irazema Garcia | Health Educator | 3000 Sand Hill Road, Building 3, Suite 240, Menlo Park, CA 94025 | 2019-01-15 |
| 1538639174 | Care Indeed, Inc. | Home Health | 890 Santa Cruz Ave., Menlo Park, CA 94025 | 2018-11-27 |
| 1639644370 | Wendy Figone | Massage Therapist | 575 Gilbert Ave., Menlo Park, CA 94025 | 2018-10-09 |
| 1437667540 | Christina E Kang | Nutritionist | 3639 Haven Ave Unit A424, Menlo Park, CA 94025 | 2018-01-11 |
| 1225492820 | Speachy Learning Center | Speech-Language Pathologist | 1164 Chestnut Street, Menlo Park, CA 94025 | 2016-04-09 |
| Find all providers in zip 94025 | ||||
| Taxonomy Code | 261QM2800X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Methadone Clinic |
| An entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction. |
| Notes: [7/1/2003: new] |
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| 1083224141 | Aegis Treatment Centers, LLC | Clinic/Center | 1450 Bessie Ave Ste B, Tracy, CA 95376-3456 | 2020-08-04 |
| 1093323222 | City and County of San Francisco | Clinic/Center | 1001 Potrero Ave # Ward86, San Francisco, CA 94110-3518 | 2020-07-14 |
| 1548899644 | Bella Team Ltd. | Clinic/Center | 2618 San Miguel Dr Ste 1288, Newport Beach, CA 92660-5437 | 2020-04-02 |
| 1386280899 | Western Pacific Med-corp | Clinic/Center | 26921 Crown Valley Pkwy Ste 200, Mission Viejo, CA 92691-6501 | 2019-11-19 |
| 1518501527 | Harmonic Solutions LLC | Clinic/Center | 1776 Ygnacio Valley Rd Ste 206, Walnut Creek, CA 94598-3125 | 2019-11-01 |
| 1326698887 | Aegis Treatment Centers, LLC | Clinic/Center | 2107, 2109 & 2113 1st St, Eureka, CA 95501-0840 | 2019-09-17 |
| 1548819550 | Aegis Treatment Centers, LLC | Clinic/Center | 1111 W Inyokern Rd Ste B, Ridgecrest, CA 93555-2370 | 2019-09-11 |
| 1306326699 | Kristen Andree Rickard | Clinic/Center | 1153 Paradise Trail Rd, Chula Vista, CA 91915-2502 | 2018-08-16 |
| 1083141600 | Baart Behavioral Health Services, Inc. | Clinic/Center | 1145 Market St Fl 10, San Francisco, CA 94103-1566 | 2017-05-13 |
| 1013448547 | Coachella Valley Treatment Center | Clinic/Center | 81709 Dr Carreon Blvd Ste B1, Indio, CA 92201-5510 | 2017-03-26 |
| Find all providers with the same taxonomy | ||||
| City | MENLO PARK |
| Zip Code | 94025 |
Please comment or provide details below to improve the information on SAN MATEO MEDICAL CENTER METHADONE TREATMENT PROGRAM.
| 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.