Dr. Jess H Ghannam
Psychologist Clinical Psychologist Forensic Psychologist Group Psychotherapist and 2 more
1335 Stanford
Emeryville
, California 94608-2536
Dr. Jess H Ghannam
Psychologist Clinical Psychologist Forensic Psychologist Group Psychotherapist and 2 more
1335 Stanford
Emeryville
, California 94608-2536
(415) 354-3377
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About
Features
Specialties
- Clinical Psychologist
- Psychologist
- Forensic Psychologist
- Group Psychotherapist
- Rehabilitation Psychologist
Languages spoken
- English
Location
First Address
- Dr. Jess H Ghannam
- 1939 Divisadero St # 3
- San Francisco, CA
- Zip : 94115-2507
- Fax : (415) 354-3377
- Phone : (415) 921-8096
Second Address
- Dr. Jess H Ghannam
- 1335 Stanford
- Emeryville, CA
- Zip : 94608-2536
- Fax : (510) 647-5105
- Phone : (510) 647-5101
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 103G00000X | Clinical Psychologist | PSY9261 | CA |
| N | 103TC0700X | Clinical Psychologist | PSY9261 | CA |
| N | 102L00000X | Psychologist | PSY9261 | CA |
| N | 103T00000X | Psychologist | PSY9261 | CA |
| Y | 103G00000X | Clinical Psychologist | PSY9261 | CA |
| Y | 103TC0700X | Clinical Psychologist | PSY9261 | CA |
| N | 103TF0200X | Forensic Psychologist | PSY9261 | CA |
| N | 103TP2701X | Group Psychotherapist | PSY9261 | CA |
| N | 103TR0400X | Rehabilitation Psychologist | PSY9261 | CA |
National Provider Identifier
| NPI | 1285790154 |
|---|---|
| Provider Name | Dr. Jess H Ghannam |
| First Address | San Francisco, CA 94115-2507 |
| Second Address | Emeryville, CA 94608-2536 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 28/12/2006 |
| Last Update Date | 05/09/2012 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| R26383 | (02) | CA |
| ZZZ20562Z | GROUP ID NUMBER (01) | CA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.