Provider Demographics
NPI:1538418025
Name:PORTER, GILES
Entity type:Individual
Prefix:MR
First Name:GILES
Middle Name:
Last Name:PORTER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1450 ENEA CIR STE 200
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94520-7955
Mailing Address - Country:US
Mailing Address - Phone:925-849-3113
Mailing Address - Fax:925-685-0377
Practice Address - Street 1:1450 ENEA CIR STE 200
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-7955
Practice Address - Country:US
Practice Address - Phone:925-849-3113
Practice Address - Fax:925-685-0377
Is Sole Proprietor?:No
Enumeration Date:2012-08-30
Last Update Date:2012-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor