Individual
DR. JUSTIN TARRANCE GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
500 PARNASSUS AVE RM 5, SAN FRANCISCO, CA 94143-2203
(415) 476-1281
Mailing address
2222 BANCROFT WAY, UNIVERSITY OF CALIFORNIA, BERKELEY, BERKELEY, CA 94720-4301
(256) 337-9064
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
29025
CA
103TB0200X
Cognitive & Behavioral Psychologist
29025
CA
103TC0700X
Clinical Psychologist
29025
CA
103TC1900X
Counseling Psychologist
29025
CA
103TH0100X
Health Service Psychologist
29025
CA
103TP2701X
Group Psychotherapy Psychologist
29025
CA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
06/09/2009
Last updated
02/15/2023
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