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1114940624
BRUCE FRASER GURGANUS
SAN RAFAEL, CA
NPI
1114940624
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor Mental Health
(Licence: CA MFT 16879)
Enumeration Date
2006-07-25
Last Update Date
2007-07-08
Business Address
BRUCE FRASER GURGANUS MFT
20 N SAN PEDRO RD STE 2021
SAN RAFAEL, CA 94903-4158
Phone number: 415-499-6769
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Mailing Address
BRUCE FRASER GURGANUS MFT
1039 CRESTON RD
BERKELEY, CA 94708-1503
Phone number: 415-499-7595
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