Provider Demographics
NPI:1104193168
Name:HOWARD, GARRETT (MS, MFT)
Entity Type:Individual
Prefix:
First Name:GARRETT
Middle Name:
Last Name:HOWARD
Suffix:
Gender:M
Credentials:MS, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5665 COLLEGE AVE
Mailing Address - Street 2:SUITE 340A
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94618-1625
Mailing Address - Country:US
Mailing Address - Phone:510-982-1280
Mailing Address - Fax:
Practice Address - Street 1:5665 COLLEGE AVE
Practice Address - Street 2:SUITE 340A
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94618-1625
Practice Address - Country:US
Practice Address - Phone:510-982-1280
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-18
Last Update Date:2016-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA88560106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist