Provider Demographics
NPI:1275652869
Name:HERRERA, GIOVANNI (PSYD)
Entity Type:Individual
Prefix:MR
First Name:GIOVANNI
Middle Name:
Last Name:HERRERA
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:760 HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94107-1235
Mailing Address - Country:US
Mailing Address - Phone:415-836-1751
Mailing Address - Fax:415-836-1737
Practice Address - Street 1:760 HARRISON ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94107-1235
Practice Address - Country:US
Practice Address - Phone:415-836-1751
Practice Address - Fax:415-836-1737
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY21631103TC0700X
CAIMF44778106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
7536OtherSFGH INTERNAL USE ONLY
7536OtherCBHS INTERNAL USE ONLY-COMMERCIAL NUMBER