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General NPI Number Information
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NPI Number | 1154083558
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Entity Type | Organization
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Legal Business Name | GREGORY ALTER GROUP, INC.
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Dates
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Enumeration Date | 10/12/2021
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Last Update Date | 10/15/2021
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Provider Practice Location Address
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Address Line | 31 CARROLL CT
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City | SAN RAFAEL
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State | CA
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Zip | 94903-3719
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Country | US
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Telephone | 510-734-0885
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Fax |
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Provider Business Mailing Address
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Address Line | 3812 LAUREL AVE
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City | OAKLAND
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State | CA
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Zip | 94602-3925
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PROVIDER/OWNER
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Name | GREGORY SETH ALTER
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Credential | PH.D.
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Telephone | 510-734-0885
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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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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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