Jennifer A Banta PHD

NPI 1629337944 - Psychologist - 103T00000X

NPI Details
NPI 1629337944
Gender Female
Enumeration Date 05/07/2012
Last Updated 05/07/2012
Entity Type Individual
Active Over 4 years ago
Practice Location
815 BUENA VISTA AVE W
WALDEN HOUSE-HAFC DUAL RECOVERY PROGRAM
SAN FRANCISCO CA, 94117-4108, US
Phone (415) 558-4206
Fax (415) 558-4235
Business Location
815 BUENA VISTA AVE W
WALDEN HOUSE-HAFC DUAL RECOVERY PROGRAM
SAN FRANCISCO CA, 94117-4108, US
Phone (415) 558-4206
Fax (415) 558-4235
Toxanomy
Taxonomy Code 103T00000X
License State California
License Number PSY20473
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According to our database, Dr. Jennifer A Banta PHD NPI is 1629337944, taxonomy code is 103T00000X and license number is PSY20473, license state is located at California. Jennifer A Banta PHD physically located at 815 Buena Vista Ave W, San Francisco CA, 94117-4108. NPI Number Jennifer A Banta PHD has the Individual type.

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1629337944 NPI number is provided on an as is basis without warranty of any kind. 1629337944 is maintained by the National Plan & Provider Enumeration System. The contents of Jennifer A Banta PHD are for informational purposes only.