Provider Demographics
NPI:1871996181
Name:GUELZOW, BRIAN TATE (PHD)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:TATE
Last Name:GUELZOW
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 1:243 FILLMORE ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94117-3536
Mailing Address - Country:US
Mailing Address - Phone:510-590-8311
Mailing Address - Fax:
Practice Address - Street 1:243 FILLMORE ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94117-3536
Practice Address - Country:US
Practice Address - Phone:510-590-8311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-30
Last Update Date:2014-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist