Healthcare Provider Details

I. General information

NPI: 1699114223
Provider Name (Legal Business Name): VICTOR SAMUEL GRESSER B.A., C.T.S
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2013
Last Update Date: 06/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1380 HOWARD ST
SAN FRANCISCO CA
94103-2638
US

IV. Provider business mailing address

1380 HOWARD ST
SAN FRANCISCO CA
94103-2638
US

V. Phone/Fax

Practice location:
  • Phone: 415-255-3699
  • Fax: 415-255-3529
Mailing address:
  • Phone: 415-255-3699
  • Fax: 415-255-3529

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: