1528168366 NPI number — DR. GREGORY SETH ALTER PH.D.

Table of content: KASCHA BROWN (NPI 1396540837)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528168366 NPI number — DR. GREGORY SETH ALTER PH.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ALTER
Provider First Name:
GREGORY
Provider Middle Name:
SETH
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PH.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1528168366
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/08/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
06/28/2022
NPI Reactivation Date:
08/08/2022

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3048 RICHMOND BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OAKLAND
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94611-5847
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
510-545-6463
Provider Business Mailing Address Fax Number:
510-217-3588

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5666 TELEGRAPH AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OAKLAND
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94609-1708
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-545-6463
Provider Business Practice Location Address Fax Number:
510-217-3588
Provider Enumeration Date:
09/22/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103G00000X , with the licence number:  PSY7422 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TA0400X , with the licence number: PSY7422 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TA0700X , with the licence number: PSY7422 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TB0200X , with the licence number: PSY7422 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TC0700X , with the licence number: PSY7422 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 103TC2200X , with the licence number: PSY7422 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TF0200X , with the licence number: PSY7422 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TH0100X , with the licence number: PSY7422 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103T00000X , with the licence number: PSY7422 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TS0200X , with the licence number: PSY7422 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 106H00000X , with the licence number: PSY7422 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)