Provider Demographics
NPI:1538518451
Name:WHOLE STEP PSYCHOLOGICAL SERVICES, INC.
Entity Type:Organization
Organization Name:WHOLE STEP PSYCHOLOGICAL SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:FORD
Authorized Official - Last Name:OGLESBY
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:650-409-6049
Mailing Address - Street 1:3150 18TH ST
Mailing Address - Street 2:STE. 107
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-2074
Mailing Address - Country:US
Mailing Address - Phone:650-409-6049
Mailing Address - Fax:415-326-3625
Practice Address - Street 1:3150 18TH ST
Practice Address - Street 2:STE. 107
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-2074
Practice Address - Country:US
Practice Address - Phone:650-409-6049
Practice Address - Fax:415-326-3625
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-10
Last Update Date:2016-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19454103TC0700X
CA41525106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty