DR. GRETCHEN W. KISHBAUGH (NPI# 1679763635) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679763635 |
| Entity Type | Individual |
| Full Name | DR. GRETCHEN W. KISHBAUGH |
| Credential | PH.D. |
| Practice Address |
1330 Lincoln Ave Suite 304a San Rafael CA 94901-2120 |
| Practice Telephone | 4154595051 |
| Mailing Telephone | 4154595051 |
| Enumeration Date | 2007-07-26 |
| Last Update Date | 2007-07-26 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
PSY16689 | CA | Behavioral Health & Social Service Providers |
| Street Address |
1330 LINCOLN AVE SUITE 304A |
| City | SAN RAFAEL |
| State | CA |
| Zip Code | 94901-2120 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972574929 | Ann Dale Rivo | Counselor | 1330 Lincoln Ave, 107, San Rafael, CA 94901-2120 | 2006-01-29 |
| 1144883695 | Ryan Gertz | Student in an Organized Health Care Education/Training Program | 1330 Lincoln Ave, San Rafael, CA 94901-2120 | 2019-04-19 |
| 1811550023 | Alexandra Giacona | Counselor | 1330 Lincoln Ave, San Rafael, CA 94901-2120 | 2019-04-15 |
| 1003336868 | Paul Kiritsis | Student in an Organized Health Care Education/Training Program | 1330 Lincoln Ave, Suite 201, San Rafael, CA 94901 | 2017-06-22 |
| 1417485459 | Casey Hineline | Counselor | 1330 Lincoln Ave, San Rafael, CA 94901-2120 | 2017-06-02 |
| 1366977670 | Nora Gift | Student in an Organized Health Care Education/Training Program | 1330 Lincoln Ave, 201, San Rafael, CA 94901-2120 | 2017-04-24 |
| 1679006191 | Raphael Amir | Student in an Organized Health Care Education/Training Program | 1330 Lincoln Ave, 201, San Rafael, CA 94901-2120 | 2017-04-11 |
| 1871025684 | Chiamaka Okwu | Student in an Organized Health Care Education/Training Program | 1330 Lincoln Ave, 201, San Rafael, CA 94901-2120 | 2017-03-30 |
| 1942732961 | Darshana Weill | Student in an Organized Health Care Education/Training Program | 1330 Lincoln Ave, Suite 201, San Rafael, CA 94901-2120 | 2017-03-29 |
| 1093247256 | Louise Franklin | Student in an Organized Health Care Education/Training Program | 1330 Lincoln Ave, Suite 201, San Rafael, CA 94901-2120 | 2017-03-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780207134 | Marianne Haissman Stefancic | Marriage & Family Therapist | 409 Forbes Ave., San Rafael, CA 94901 | 2020-05-20 |
| 1093292765 | Marin Community Clinic | Clinic/Center | 411 4th Strteet, Suite A, San Rafael, CA 94901 | 2018-07-25 |
| 1275052516 | Laura Ellen Silverstein | Marriage & Family Therapist | 600 Fifth Avenue, San Rafael, CA 94901 | 2017-09-19 |
| 1689101107 | Marin Family Recovery | Clinic/Center | 1209 Third St. Ste 4, San Rafael, CA 94901 | 2017-05-15 |
| 1376070011 | Tencia Beavers-sanchez | Counselor | 710 C Street Suite#8, Marin Outpatient&recoveryservices, Sanrafael, CA 94901 | 2017-05-12 |
| 1326584905 | Jamie Waterman | Emergency Medical Technician, Basic | 675 Sir Francis Drake Blvd, Kentfield, CA 94901 | 2017-01-06 |
| 1295270676 | Stephen Marks | Counselor | 900 Fifth Avenue, Suite 150, ; San Rafael, CA 94901 | 2016-12-21 |
| 1497299812 | Vesna Sturman | Psychologist | 712 D St Ste L, San Rafael, CA 94901 | 2016-12-05 |
| 1063955771 | Carol Dutton Hollenberg | Behavior Technician | 503 D St., San Rafael, CA 94901 | 2016-11-29 |
| 1083069447 | Bay Area Community Resources | Community/Behavioral Health | 103 Shoreline Parkway, San Rafael, CA 94901 | 2016-05-04 |
| Find all providers in zip 94901 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871135665 | Tina M Galordi | Psychologist | 1414 4th St Ste 201, San Rafael, CA 94901-2857 | 2019-10-13 |
| 1497299812 | Vesna Sturman | Psychologist | 712 D St Ste L, San Rafael, CA 94901 | 2016-12-05 |
| 1134581986 | Stephen Willis | Psychologist | 4460 Redwood Hwy # 16-320, San Rafael, CA 94903-1951 | 2016-03-22 |
| 1720367956 | Albert Wong | Psychologist | 1 H Street, Suite 203, San Rafael, CA 94901 | 2011-08-05 |
| 1932497377 | Jessica Erin Pullins | Psychologist | 1299 4th St Ste 401, San Rafael, CA 94901-3030 | 2011-07-19 |
| 1194031872 | Duy D. Vu | Psychologist | 4460 Redwood Hwy Ste 16-303, San Rafael, CA 94903-1951 | 2010-08-19 |
| 1871826487 | Aninha Esperanza Livingstone | Psychologist | 700 E St San Rafael Ca 94901, Suite 201, San Rafael, CA 94901 | 2009-09-14 |
| 1609012574 | Ruud Vanwijnen | Psychologist | 15 North Ave, 2-a, San Rafael, CA 94903-4823 | 2008-12-26 |
| 1033386768 | Boukje Elisabeth Eerkens | Psychologist | 101 Lucas Valley Rd Ste 269, San Rafael, CA 94903-1761 | 2008-05-12 |
| 1255547154 | Geraldine Alpert | Psychologist | 33 Bungalow Ave, San Rafael, CA 94901-5140 | 2007-05-15 |
| Find all providers in SAN RAFAEL | ||||
| City | SAN RAFAEL |
| Zip Code | 94901 |
Please comment or provide details below to improve the information on DR. GRETCHEN W. KISHBAUGH.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.