Provider Demographics
NPI:1164639563
Name:EGAN, ROBERT RICHARD (BS, MSSE)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:RICHARD
Last Name:EGAN
Suffix:
Gender:M
Credentials:BS, MSSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2441 JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-1324
Mailing Address - Country:US
Mailing Address - Phone:415-346-6380
Mailing Address - Fax:415-346-1058
Practice Address - Street 1:2441 JACKSON ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-1324
Practice Address - Country:US
Practice Address - Phone:415-346-6380
Practice Address - Fax:415-346-1058
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health