Provider Demographics
NPI:1326203415
Name:HOEBER, GARY MICHAEL (MFT)
Entity Type:Individual
Prefix:
First Name:GARY
Middle Name:MICHAEL
Last Name:HOEBER
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 SHATTUCK AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94709-1601
Mailing Address - Country:US
Mailing Address - Phone:510-548-8721
Mailing Address - Fax:
Practice Address - Street 1:1600 SHATTUCK AVE STE 200
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94709-1601
Practice Address - Country:US
Practice Address - Phone:510-548-8721
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-28
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC17871106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist