Provider Demographics
NPI:1639194673
Name:CURTIS, JOHN T (PHD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:T
Last Name:CURTIS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3368 SACRAMENTO ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94118-1912
Mailing Address - Country:US
Mailing Address - Phone:415-346-2744
Mailing Address - Fax:415-454-3683
Practice Address - Street 1:3368 SACRAMENTO ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118-1912
Practice Address - Country:US
Practice Address - Phone:415-346-2744
Practice Address - Fax:415-454-3683
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY6545103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00PL65450Medicare UPIN