Provider Demographics
NPI:1306216791
Name:GHERE, JAMES ALAN
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:ALAN
Last Name:GHERE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:509 6TH ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-4707
Mailing Address - Country:US
Mailing Address - Phone:415-222-6150
Mailing Address - Fax:415-222-6165
Practice Address - Street 1:509 6TH ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-4707
Practice Address - Country:US
Practice Address - Phone:415-222-6150
Practice Address - Fax:415-222-6165
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-29
Last Update Date:2015-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA10416104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker