MEDICARE: DR. GINGER RHODES PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	PSY20214	CA

General Provider Information

NPI Number	:	1104898485
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GINGER RHODES PHD

Provider Business Mailing Address
First Line	:	PO BOX 1434
Second Line	:
City	:	EL GRANADA
State	:	CA
Zip	:	94018-1434
Country	:	US
Telephone Number	:	415-420-7318
Fax Number	:

Provider Business Practice Location Address
First Line	:	3884 24TH ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94114-3839
Country	:	US
Telephone Number	:	415-420-7318
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/02/2006
Last Update Date	:	03/01/2017

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