Provider Information for 1851469894
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STEPHEN JACK ALTBAUM M.F.T.
Sex: Male
NPI: 1851469894
Last Updated: 2015-05-22
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1851469894 | ||||||||
| Enumeration Date | 2006-11-30 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 3553 WHIPPLE ROAD UNION CITY, CA 94587-1507 United States Phone: 510-454-1000 | Fax: | ||||||||
| Primary Practice Address | 3555 WHIPPLE ROAD UNION CITY, CA 94587-1507 United States Phone: 510-454-1000 | Fax: | ||||||||
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