Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103G00000X | Clinical Psychologist | PSY7422 | CA |
N | 103TC0700X | Clinical Psychologist | PSY7422 | CA |
N | 102L00000X | Psychologist | PSY7422 | CA |
N | 103T00000X | Psychologist | PSY7422 | CA |
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | PSY7422 | CA |
N | 103TA0700X | Adult Development & Aging Psychologist | PSY7422 | CA |
N | 103TB0200X | Cognitive & Behavioral Psychologist | PSY7422 | CA |
Y | 103G00000X | Clinical Psychologist | PSY7422 | CA |
Y | 103TC0700X | Clinical Psychologist | PSY7422 | CA |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | PSY7422 | CA |
N | 103TF0200X | Forensic Psychologist | PSY7422 | CA |
N | 103TH0100X | Health Service | PSY7422 | CA |
N | 103TS0200X | School Psychologist | PSY7422 | CA |
NPI | 1528168366 |
---|---|
Provider Name | Dr. Gregory Seth Alter |
First Address | Oakland, CA 94611-5847 |
Second Address | Oakland, CA 94609-1708 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/09/2006 |
Last Update Date | 23/06/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
R27720 | (02) | CA |