Provider Demographics
NPI:1609910256
Name:FILANOSKY, CHARLES A (PHD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:A
Last Name:FILANOSKY
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 1:4444 GEARY BLVD
Mailing Address - Street 2:SUITE 309C
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94118-3048
Mailing Address - Country:US
Mailing Address - Phone:650-839-3486
Mailing Address - Fax:
Practice Address - Street 1:4444 GEARY BLVD
Practice Address - Street 2:SUITE 309C
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118-3048
Practice Address - Country:US
Practice Address - Phone:650-839-3486
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-16
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22571103G00000X
NY017080-01103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist