EDGEWOOD CENTER (NPI# 1932341716) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932341716 |
| Entity Type | Organization |
| Organization Name | EDGEWOOD CENTER |
| Practice Address |
1801 Vicente St San Francisco CA 94116-2923 |
| Mailing Address |
1801 Vicente St San Francisco CA 94116 |
| Practice Telephone | 4156813211 |
| Mailing Telephone | 4156813211 |
| Enumeration Date | 2009-03-25 |
| Last Update Date | 2009-03-25 |
| Authorized Official Name | MR. BRIAN KEITH BENEFIELD (ASSISTANT TREATMENT MANAGER) |
| Authorized Official Telephone | 4157250663 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568742823 | Edgewood Center | Residential Treatment Facility, Emotionally Disturbed Children | 1801 Vicente Ave, San Francisco, CA 94116 | 2011-08-18 |
| 1487711073 | Edgewood Center | Residential Treatment Facility, Emotionally Disturbed Children | 1801 Vicente St, San Francisco, CA 94116-2923 | 2007-01-02 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | EDGEWOOD CENTER LLC | 909 Meridian Ave E, Edgewood, WA 98371-1067 |
| Street Address |
1801 VICENTE ST |
| City | SAN FRANCISCO |
| State | CA |
| Zip Code | 94116-2923 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437253721 | Deborah Ernestine Kopec | Registered Nurse | 1801 Vicente St, Edgewood Center for Children and Families, San Francisco, CA 94116-2923 | 2006-09-08 |
| 1235730375 | Nadia Lynn Rohlfs | Counselor | 1801 Vicente St, San Francisco, CA 94116-2923 | 2020-11-05 |
| 1396344255 | Hillary Chu | Registered Nurse | 1801 Vicente St, San Francisco, CA 94116-2923 | 2020-10-21 |
| 1285233353 | Thais Schwab | Counselor | 1801 Vicente St, San Francisco, CA 94116-2923 | 2020-10-20 |
| 1205434081 | Danyel Janet Kizzie Cheathon | Community Health Worker | 1801 Vicente St, San Francisco, CA 94116-2923 | 2020-10-13 |
| 1063010072 | Ariel Jaynus De Vera Buendia | Community Health Worker | 1801 Vicente St, San Francisco, CA 94116-2923 | 2020-10-12 |
| 1902404916 | Rachael Ann Wolf | Community Health Worker | 1801 Vicente St, San Francisco, CA 94116-2923 | 2020-10-12 |
| 1073120556 | Rezia Pearl Leopando | Community Health Worker | 1801 Vicente St, San Francisco, CA 94116-2923 | 2020-09-28 |
| 1982211546 | Lauren Marie Barretto | Counselor | 1801 Vicente St, San Francisco, CA 94116-2923 | 2020-09-28 |
| 1295342384 | Sarah Kral | Marriage & Family Therapist | 1801 Vicente St, San Francisco, CA 94116-2923 | 2020-09-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386275972 | Eric Lee | Behavior Technician | 2000 43rd Ave, San Francisco, CA 94116 | 2020-01-31 |
| 1376103176 | Young-in Kim | Physical Therapist | 3401 Taraval St, San Francisco, CA 94116 | 2019-06-14 |
| 1952806408 | Ramirez & Xia Dental Corp. | Dentist | 2409 Taraval St., San Francisco, CA 94116 | 2018-03-27 |
| 1043739337 | Cindi Lam | Community Health Worker | 375 Laguna Honda Blvd., B200, San Francisco, CA 94116 | 2017-09-18 |
| 1043735442 | Tammy Marie Buhler | Community Health Worker | 1990 41st Avenue, San Francisco, CA 94116 | 2017-08-07 |
| 1457875015 | Janet Bilafer-steiner | Nurse Practitioner | 2935 Travel Street, San Francisco, CA 94116 | 2017-07-26 |
| 1790225811 | Christopher Valles-martinez | Counselor | 1801 Vicente St, San Francisco, CA 94116 | 2017-03-08 |
| 1033659578 | Emiko Perez | Technician, Other | 2235 31st Ave, San Francisco, CA 94116 | 2017-03-02 |
| 1982070249 | Elizabeth Ancker | Counselor | 1800 Vicente Street, San Francisco, CA 94116 | 2015-08-20 |
| 1922432608 | Toby Wai Chang | Pharmacist | 2354 32nd Ave, San Francisco, CA 94116 | 2013-08-29 |
| Find all providers in zip 94116 | ||||
| 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 |
|---|---|---|---|---|
| 1134650070 | Nalls Foundation | Residential Treatment Facility, Emotionally Disturbed Children | 131 Persia Ave, San Francisco, CA 94112-2717 | 2017-03-22 |
| 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 |
| 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 | 94116 |
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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.