Individual
GOUVERNEUR M CARNOCHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
10 FUNSTON AVE, SAN FRANCISCO, CA 94129-1109
(415) 793-6511
Mailing address
10 FUNSTON AVE, SAN FRANCISCO, CA 94129-1109
(415) 793-6511
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
15189
CA
Other
Enumeration date
01/24/2018
Last updated
01/24/2018
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