Provider Demographics
NPI:1093981516
Name:GORDON, ROBERT SETH (MFT)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:SETH
Last Name:GORDON
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:DR
Other - First Name:ROBERT
Other - Middle Name:SETH
Other - Last Name:GORDON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MFT
Mailing Address - Street 1:405 CLEMENT ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94118-2317
Mailing Address - Country:US
Mailing Address - Phone:415-668-1149
Mailing Address - Fax:415-381-4520
Practice Address - Street 1:405 CLEMENT ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118-2317
Practice Address - Country:US
Practice Address - Phone:415-668-1149
Practice Address - Fax:415-381-4520
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-05
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT14648103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling