Healthcare Provider Details

I. General information

NPI: 1699339820
Provider Name (Legal Business Name): SPENCER CHARLES GILBERT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/23/2019
Last Update Date: 10/07/2025
Certification Date: 10/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 FRANKLIN ST
SAN FRANCISCO CA
94109-4523
US

IV. Provider business mailing address

1500 FRANKLIN ST
SAN FRANCISCO CA
94109-4523
US

V. Phone/Fax

Practice location:
  • Phone: 415-474-7310
  • Fax:
Mailing address:
  • Phone: 415-474-7310
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberAPCC20195
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: