Individual
DR. GRETCHEN W. KISHBAUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1330 LINCOLN AVE, SUITE 304A, SAN RAFAEL, CA 94901-2120
(415) 459-5051
Mailing address
1330 LINCOLN AVE, SUITE 304A, SAN RAFAEL, CA 94901-2120
(415) 459-5051
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY16689
CA
Other
Enumeration date
07/26/2007
Last updated
07/26/2007
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