CATHOLIC CHARITIES CYO OF THE ARCHDIOCESE OF SAN FRANCISCO (NPI# 1538223300) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538223300 |
| Entity Type | Organization |
| Organization Name | CATHOLIC CHARITIES CYO OF THE ARCHDIOCESE OF SAN FRANCISCO |
| Other Organization Name | ST. VINCENT'S SCHOOL FOR BOYS |
| Practice Address |
1 Saint Vincents Dr San Rafael CA 94903-1504 |
| Mailing Address |
990 Eddy St San Francisco CA 94109-7713 |
| Practice Telephone | 4155072000 |
| Mailing Telephone | 4155072000 |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2015-04-28 |
| Authorized Official Name | MR. KENT EAGLESON (DIRECTOR) |
| Authorized Official Telephone | 4155074292 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251S00000X | Community/Behavioral Health | Agencies | ||
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | 216801396 | CA | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| St. Vincent's School for Boys | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811129703 | Catholic Charities Cyo of The Archdiocese of San Francisco | Community/Behavioral Health | 727 Golden Gate Ave, San Francisco, CA 94102-3101 | 2009-08-11 |
| 1861681868 | Catholic Charities Cyo of The Archdiocese of San Francisco | Community/Behavioral Health | 750 33rd Ave, San Francisco, CA 94121-3428 | 2007-10-16 |
| 1629158431 | Catholic Charities Cyo of The Archdiocese of San Francisco | Community/Behavioral Health | 990 Eddy St, San Francisco, CA 94109-7713 | 2006-10-16 |
| 1821280132 | Catholic Charities Cyo of The Archdiocese of San Francisco | Community/Behavioral Health | 823 Euclid Ave, San Francisco, CA 94118-2510 | 2007-08-10 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | CATHOLIC CHARITIES CYO OF THE ARCHDIOCESE OF SAN FRANCISCO | 990 Eddy St, San Francisco, CA 94109-7713 |
| Street Address |
1 SAINT VINCENTS DR |
| City | SAN RAFAEL |
| State | CA |
| Zip Code | 94903-1504 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770688582 | Sonia Raquel Cavazos | Marriage & Family Therapist | 1 Saint Vincents Dr, San Rafael, CA 94903-1504 | 2006-09-14 |
| 1760039069 | Anyssa N Haberkorn-gomez | Student in an Organized Health Care Education/Training Program | 1 Saint Vincents Dr, San Rafael, CA 94903-1504 | 2019-08-21 |
| 1205309366 | Nancy Freitas Lambert | Psychologist | 1 Saint Vincents Dr, San Rafael, CA 94903-1504 | 2019-01-10 |
| 1710450960 | Joseph Anthony Emard | Counselor | 1 Saint Vincents Dr, San Rafael, CA 94903-1504 | 2019-01-09 |
| 1902378482 | Catherine Serrano Florendo | Counselor | 1 Saint Vincents Dr, San Rafael, CA 94903-1504 | 2018-12-21 |
| 1619452471 | Kathryn Dulay Wisniewski | Counselor | 1 Saint Vincents Dr, San Rafael, CA 94903-1504 | 2018-09-27 |
| 1356829287 | Christine Lewis | Counselor | 1 Saint Vincents Dr, San Rafael, CA 94903 | 2018-08-02 |
| 1285126201 | Lauraleigh Carol Hungerford | Counselor | 1 Saint Vincents Dr, San Rafael, CA 94903 | 2018-06-05 |
| 1194217117 | Reanne Elise Remlinger | Counselor | 1 Saint Vincents Dr, San Rafael, CA 94903 | 2018-06-05 |
| 1467942243 | Monique Mercado | Counselor | 1 Saint Vincents Dr, San Rafael, CA 94903 | 2018-05-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467089524 | Christopher Sazo | Counselor | 1 St. Vincents Drive, San Rafael, CA 94903 | 2020-03-26 |
| 1134769482 | Katherine Sieger | Music Therapist | 400 Civic Center Dr. #300, San Rafael, CA 94903 | 2020-01-14 |
| 1679064836 | California In Home Care & Registry, Inc | In Home Supportive Care | 14b Mitchell Blvd, Suite B, San Rafael, CA 94903 | 2018-05-23 |
| 1922557586 | Helen Elizabeth Shamis | Marriage & Family Therapist | 30 North San Pedro, Suite #265, Beyond Hunger, San Rafael, CA 94903 | 2016-09-23 |
| 1033572771 | Henry Colbert | Counselor | 1 St. St. Vincent Drive, San Rafael, CA 94903 | 2016-03-31 |
| 1659736924 | Robyn Bloom | Marriage & Family Therapist | 4 Joseph Court, San Rafael, CA 94903 | 2015-12-30 |
| 1851760565 | Cheryl Clementson | Substance Abuse Rehabilitation Facility | 301 Smith Ranch Road, San Rafael, CA 94903 | 2015-09-23 |
| 1588043731 | Chelsea Cooney | Counselor | 1 St. Vincent's Drive, San Rafael, CA 94903 | 2015-05-20 |
| 1083002315 | Kaiser Permanente | Psychiatric Unit | 111 Smith Ranch Road, Kaiser Permanente, San Rafael, CA 94903 | 2015-01-09 |
| 1366857856 | Travel Well Corporation | Preventive Medicine | 28 Mitchell Blvd, San Rafael, CA 94903 | 2014-06-24 |
| Find all providers in zip 94903 | ||||
| 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 |
|---|---|---|---|---|
| 1659670008 | Cathlic Charities Cyo | Residential Treatment Facility, Emotionally Disturbed Children | 1 St.vincent Dr, San Rafael, CA 94903 | 2011-03-24 |
| 1174066476 | St. Vincent's School for Boys | Residential Treatment Facility, Emotionally Disturbed Children | 1 Saint Vincents Dr, San Rafael, CA 94903-1504 | 2016-11-18 |
| 1417234972 | Sean Michael Mcgraw | Residential Treatment Facility, Emotionally Disturbed Children | 1 Saint Vincents Dr, San Rafael, CA 94903-1504 | 2011-11-12 |
| 1225327786 | St Vincents | Residential Treatment Facility, Emotionally Disturbed Children | 1 Saint Vincents Dr, San Rafael, CA 94903-1504 | 2011-04-05 |
| 1710042650 | Catholic Charities Cyo | Residential Treatment Facility, Emotionally Disturbed Children | 1 Saint Vincents Dr, San Rafael, CA 94903-1504 | 2006-12-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144820499 | Catholic Charities of The Diocese of Oakland | Residential Treatment Facility, Emotionally Disturbed Children | 3700 Dorisa Ave, Oakland, CA 94605-4941 | 2020-10-27 |
| 1922607944 | Inspire A Youth, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 7556 Avenida Baja, Riverside, CA 92509-3449 | 2020-10-21 |
| 1235736554 | Yvonne Dionne Robinson | Residential Treatment Facility, Emotionally Disturbed Children | 1223 E Helmick St, Carson, CA 90746-3163 | 2020-10-09 |
| 1740897784 | Paradise Adolescent Home, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 602 Woodlark Dr, Suisun City, CA 94585-2244 | 2020-09-24 |
| 1548877657 | T & T House of Champions | Residential Treatment Facility, Emotionally Disturbed Children | 2115 High St, Oakland, CA 94601-4335 | 2020-09-23 |
| 1902412182 | Paradise Adolescent Home, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 136 Valdivia Cir, San Ramon, CA 94583-2228 | 2020-09-22 |
| 1073128492 | Samuel Campbell Jr. | Residential Treatment Facility, Emotionally Disturbed Children | 4200 Crescent Rock Ln, Bakersfield, CA 93311-2860 | 2020-09-11 |
| 1336753433 | Aaron's Boys Home | Residential Treatment Facility, Emotionally Disturbed Children | 5805 Capistrano Ave Ste E, Atascadero, CA 93422-7218 | 2020-09-04 |
| 1699389452 | Millie's Youth Services, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 2512 Havenscourt Blvd, Oakland, CA 94605-1935 | 2020-08-31 |
| 1538779871 | Hidden Treasures Foundation, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 1240 W 13th Ave, Escondido, CA 92025-5560 | 2020-08-02 |
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| City | SAN RAFAEL |
| Zip Code | 94903 |
Please comment or provide details below to improve the information on CATHOLIC CHARITIES CYO OF THE ARCHDIOCESE OF SAN FRANCISCO.
| 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.