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General NPI Number Information
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NPI Number | 1104047562
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Entity Type | Organization
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Legal Business Name | BULLARD PSYCHOLOGY CONSULTING, INC.
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Dates
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Enumeration Date | 05/02/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1968 GREEN ST
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City | SAN FRANCISCO
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State | CA
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Zip | 94123-4811
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Country | US
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Telephone | 415-239-1584
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Fax |
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Provider Business Mailing Address
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Address Line | 1968 GREEN ST
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City | SAN FRANCISCO
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State | CA
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Zip | 94123-4811
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Country | US
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Telephone | 415-239-1584
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAVID GILMORE BULLARD
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Credential | PH.D.
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Telephone | 415-239-1584
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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 | PSY4843
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License Number State | CA
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