Individual
GARY HENNEMUTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
1918 UNIVERSITY AVE STE 201, BERKELEY, CA 94704-3264
(510) 548-9716
Mailing address
3150 18TH ST STE 507, SAN FRANCISCO, CA 94110-2077
(415) 617-9323
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY33414
CA
Other
Enumeration date
10/13/2015
Last updated
07/22/2023
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