Provider Demographics
NPI:1528168366
Name:ALTER, GREGORY SETH (PHD)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:SETH
Last Name:ALTER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3048 RICHMOND BLVD
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94611-5847
Mailing Address - Country:US
Mailing Address - Phone:510-545-6463
Mailing Address - Fax:510-217-3588
Practice Address - Street 1:5666 TELEGRAPH AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-1708
Practice Address - Country:US
Practice Address - Phone:510-545-6463
Practice Address - Fax:510-217-3588
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2022-08-08
Deactivation Date:2022-06-28
Deactivation Code:
Reactivation Date:2022-08-08
Provider Licenses
StateLicense IDTaxonomies
CAPSY7422103G00000X, 103TA0400X, 103TA0700X, 103TB0200X, 103TC0700X, 103TC2200X, 103TF0200X, 103TH0100X, 103T00000X, 103TS0200X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)
No103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & Aging
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic
No103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAR27720Medicare UPIN
CA0PL742200Medicare ID - Type Unspecified