Provider Demographics
NPI:1184872798
Name:DENNIS-GREGORY, CLARE H (MFT)
Entity type:Individual
Prefix:
First Name:CLARE
Middle Name:H
Last Name:DENNIS-GREGORY
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 BON AIR RD
Mailing Address - Street 2:SUITE 240
Mailing Address - City:GREENBRAE
Mailing Address - State:CA
Mailing Address - Zip Code:94904-1752
Mailing Address - Country:US
Mailing Address - Phone:415-717-5786
Mailing Address - Fax:
Practice Address - Street 1:350 BON AIR RD
Practice Address - Street 2:SUITE 240
Practice Address - City:GREENBRAE
Practice Address - State:CA
Practice Address - Zip Code:94904-1752
Practice Address - Country:US
Practice Address - Phone:415-717-5786
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-08
Last Update Date:2008-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP1600X
CALMFT 42358106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral