Gannon, Joseph Patrick
Gannon, Joseph Patrick is an individual health care provider with primary practice located at 4445 Eastgate Mall Ste 200 , San Diego CA 92121-1979. He recently has only one registered license in Behavioral Health & Social Service Providers / Cognitive & Behavioral, which is considered as his primary health care specialty. Gannon, Joseph Patrick can be contacted via phone (858) 705-5439.Contact Information
Primary practice address
4445 Eastgate Mall Ste 200
San Diego CA 92121-1979
Phone: (858) 705-5439
Fax: (858) 771-1078
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Cognitive & Behavioral | 103TB0200X | PSY12034 | California |
Profile Details
| NPI number | 1467440347 |
|---|---|
| LBN Legal business name | Gannon, Joseph Patrick |
| Credentials | PH.D. |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 13th, 2005 |
| Last updated | Jul 30th, 2022 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1467440347 | NPPES |
| California | Other | OPL120340 | BLUE SHIELD/BLUE CROSS |
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