Provider Demographics
NPI:1285709634
Name:GAMMON, RUTH A (PHD, LCSW)
Entity type:Individual
Prefix:DR
First Name:RUTH
Middle Name:A
Last Name:GAMMON
Suffix:
Gender:F
Credentials:PHD, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 15TH ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-5103
Mailing Address - Country:US
Mailing Address - Phone:415-682-3293
Mailing Address - Fax:415-865-3099
Practice Address - Street 1:101 15TH ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-5103
Practice Address - Country:US
Practice Address - Phone:415-682-3293
Practice Address - Fax:415-865-3099
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY20855103T00000X
CALCS151811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical