Provider Demographics
NPI:1750429494
Name:PROCTOR, VICTORIA G
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:G
Last Name:PROCTOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:VICTORIA
Other - Middle Name:ELLEN
Other - Last Name:GARRETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1051 POST ST
Mailing Address - Street 2:#26
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-5666
Mailing Address - Country:US
Mailing Address - Phone:415-864-3057
Mailing Address - Fax:415-864-3163
Practice Address - Street 1:1175 HOWARD ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-3926
Practice Address - Country:US
Practice Address - Phone:415-864-3057
Practice Address - Fax:415-864-3163
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)