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General NPI Number Information
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NPI Number | 1033933775
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Entity Type | Organization
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Legal Business Name | GOLDEN GATE PSYCHOLOGY INC.
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Dates
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Enumeration Date | 11/11/2024
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Last Update Date | 11/11/2024
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Provider Practice Location Address
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Address Line | 1732 FILLMORE ST
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City | SAN FRANCISCO
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State | CA
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Zip | 94115-3130
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Country | US
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Telephone | 415-691-7535
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Fax |
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Provider Business Mailing Address
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Address Line | 3739 BALBOA ST # 1077
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City | SAN FRANCISCO
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State | CA
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Zip | 94121-2605
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Country | US
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Telephone |
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Fax | 415-418-2337
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Authorized Official
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Title or Position | SECRETARY
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Name | BENJAMIN GREENBERG
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Credential | PSYD
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Telephone | 415-691-7535
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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