Ghannam, Jess H
Ghannam, Jess H is an sole proprietor health care provider with primary practice located at 1335 Stanford , Emeryville CA 94608-2536. He recently has 7 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical Neuropsychologist, Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Forensic, Behavioral Health & Social Service Providers / Group Psychotherapy, Behavioral Health & Social Service Providers / Rehabilitation, Allopathic & Osteopathic Physicians / Pain Medicine. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Ghannam, Jess H can be contacted via phone (510) 647-5101.Contact Information
Primary practice address
1335 Stanford
Emeryville CA 94608-2536
Phone: (510) 647-5101
Fax: (510) 647-5105
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical Neuropsychologist | 103G00000X | PSY9261 | California |
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | PSY9261 | California |
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | PSY9261 | California |
| Behavioral Health & Social Service Providers / Forensic | 103TF0200X | PSY9261 | California |
| Behavioral Health & Social Service Providers / Group Psychotherapy | 103TP2701X | PSY9261 | California |
| Behavioral Health & Social Service Providers / Rehabilitation | 103TR0400X | PSY9261 | California |
| Allopathic & Osteopathic Physicians / Pain Medicine | 2084P2900X | PSY9261 | California |
Profile Details
| NPI number | 1285790154 |
|---|---|
| LBN Legal business name | Ghannam, Jess H |
| Credentials | PHD |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 28th, 2006 |
| Last updated | Sep 5th, 2012 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1285790154 | NPPES |
| California | Other | ZZZ20562Z | GROUP ID NUMBER |
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