Healthcare Provider Details

I. General information

NPI: 1699186858
Provider Name (Legal Business Name): JOSEPH GRASSO PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/09/2014
Last Update Date: 09/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

582 MARKET ST STE 210
SAN FRANCISCO CA
94104-5303
US

IV. Provider business mailing address

582 MARKET ST STE 210
SAN FRANCISCO CA
94104-5303
US

V. Phone/Fax

Practice location:
  • Phone: 415-857-2293
  • Fax:
Mailing address:
  • Phone: 415-857-2293
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TH0004X
TaxonomyHealth Psychologist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number28650
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: