Provider Demographics
NPI:1063447589
Name:PLANTE, THOMAS GERARD (PHD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:GERARD
Last Name:PLANTE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:885 OAK GROVE AVE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:MENLO PARK
Mailing Address - State:CA
Mailing Address - Zip Code:94025-4433
Mailing Address - Country:US
Mailing Address - Phone:408-554-4471
Mailing Address - Fax:408-554-5241
Practice Address - Street 1:885 OAK GROVE AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:MENLO PARK
Practice Address - State:CA
Practice Address - Zip Code:94025-4433
Practice Address - Country:US
Practice Address - Phone:408-554-4471
Practice Address - Fax:408-554-5241
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY11002103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical