Provider Demographics
NPI:1215178868
Name:FRANCO, JEAN CHANCE (PHD)
Entity Type:Individual
Prefix:DR
First Name:JEAN
Middle Name:CHANCE
Last Name:FRANCO
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2140 SHATTUCK AVE STE 710
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94704-1228
Mailing Address - Country:US
Mailing Address - Phone:510-841-1100
Mailing Address - Fax:510-841-1101
Practice Address - Street 1:2140 SHATTUCK AVE STE 710
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94704-1228
Practice Address - Country:US
Practice Address - Phone:510-841-1100
Practice Address - Fax:510-841-1101
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-11
Last Update Date:2013-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 21262103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical