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MISS CHARLENE JADE CRISOSTOMO PREMYODHIN NPI 1225249071


NPI Information

NPI: 1225249071
Provider Name: MISS CHARLENE JADE CRISOSTOMO PREMYODHIN
Classification: Community/Behavioral Health - 251S00000X
Entity Type: Individual
Address:
312 PLYMOUTH AVE
SAN FRANCISCO, CA
ZIP 94112
Phone: (714) 452-7776
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MISS Charlene Jade Crisostomo Premyodhin is a community behavioral health in San Francisco, CA. The provider is a private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. MISS Charlene Jade Crisostomo Premyodhin NPI is 1225249071. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

312 PLYMOUTH AVE
SAN FRANCISCO, CA
ZIP 94112-026
Phone: (714) 452-7776
Fax: (415) 776-1006

The enumeration date for this NPI number is 5/24/2007 and was last updated on 7/8/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1251S00000XCommunity/Behavioral HealthYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
138BF3MEDICAIDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.