Individual provider · Type 1 NPI
Samuel John Gallagher-Stevens
Mental Illness Community Based Residential Treatment Facility · San Mateo, CA
NPI number
1962870519
Active
Practice location
411 Borel Ave
San Mateo, CA 94402-3522
Mailing address
1410 Marshall Street
San Mateo, CA 94401
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Community Health Worker | 172V00000X | None listed |
| Counselor | 101Y00000X | None listed |
| Mental Illness Community Based Residential Treatment Facility Primary | 320800000X | None listed |
Mental Illness Community Based Residential Treatment Facility: A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.
Another provider at this address
About NPI 1962870519
Samuel John Gallagher-Stevens's National Provider Identifier is 1962870519, issued on Sep 11, 2015. The primary taxonomy on file is Mental Illness Community Based Residential Treatment Facility (320800000X), and the practice location is in San Mateo, CA. The record was last updated on Sep 18, 2026.