Jess H. Ghannam, PHD, Inc.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY 9261 Issued in CA

Legal business name

JESS H. GHANNAM, PHD, INC.

Practice address

1939 Divisadero St Ste 3
San Francisco, CA 94115-2507

Phone

(415) 921-8096

Fax

(415) 354-3377

NPI assigned

Sep 5, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Jess H Ghannam, PHD

Title

President/Owner

Phone

(415) 921-8096

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1346803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346803200000",
    "number": "1730438722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1939 DIVISADERO ST STE 3",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941152507",
            "telephone_number": "415-921-8096",
            "fax_number": "415-354-3377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1939 DIVISADERO ST STE 3",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941152507",
            "telephone_number": "415-921-8096",
            "fax_number": "415-354-3377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JESS H. GHANNAM, PHD, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-05",
        "last_updated": "2012-09-05",
        "status": "A",
        "authorized_official_last_name": "GHANNAM",
        "authorized_official_first_name": "JESS",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "415-921-8096",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY 9261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.