Provider Demographics
NPI:1821753427
Name:HECHT, JUSTIN BERNARD (PHD)
Entity Type:Individual
Prefix:
First Name:JUSTIN
Middle Name:BERNARD
Last Name:HECHT
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 1:3450 SACRAMENTO ST # 411
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94118-1914
Mailing Address - Country:US
Mailing Address - Phone:415-902-7602
Mailing Address - Fax:
Practice Address - Street 1:3241 SACRAMENTO ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-2047
Practice Address - Country:US
Practice Address - Phone:415-902-7602
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-08
Last Update Date:2021-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16574103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical