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General NPI Number Information
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NPI Number | 1578292082
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Entity Type | Organization
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Legal Business Name | GREGORY ALTER GROUP
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Dates
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Enumeration Date | 06/09/2022
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Last Update Date | 10/05/2023
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Provider Practice Location Address
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Address Line | 3093 BROADWAY UNIT PH76
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City | OAKLAND
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State | CA
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Zip | 94611-5779
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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 | 3093 BROADWAY UNIT PH-76
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City | OAKLAND
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State | CA
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Zip | 94611-5779
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Country | US
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Telephone | 510-734-0885
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Fax | 510-217-3588
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Authorized Official
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Title or Position | CEO
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Name | DR. GREGORY S 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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