Healthcare Provider Details

I. General information

NPI: 1942455399
Provider Name (Legal Business Name): JONATHAN EDWARD FRENCH PH.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/27/2008
Last Update Date: 11/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 20TH ST
SAN FRANCISCO CA
94107-2809
US

IV. Provider business mailing address

1500 20TH ST
SAN FRANCISCO CA
94107-2809
US

V. Phone/Fax

Practice location:
  • Phone: 415-282-2252
  • Fax: 415-282-2252
Mailing address:
  • Phone: 415-282-2252
  • Fax: 415-282-2252

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License NumberPSY7017
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: