Basic Information
Provider Information
NPI: 1427702281
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FORSHEE
FirstName: GARRET
MiddleName: M
NamePrefix:  
NameSuffix:  
Credential: LCSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 725 WELCH RD
Address2:  
City: PALO ALTO
State: CA
PostalCode: 943041601
CountryCode: US
TelephoneNumber: 6504978000
FaxNumber:  
Practice Location
Address1: 725 WELCH RD
Address2:  
City: PALO ALTO
State: CA
PostalCode: 943041601
CountryCode: US
TelephoneNumber: 6504978000
FaxNumber:  
Other Information
ProviderEnumerationDate: 02/09/2022
LastUpdateDate: 06/28/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/28/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1041C0700X69914CAN Behavioral Health & Social Service ProvidersSocial WorkerClinical
104100000X69914CAY Behavioral Health & Social Service ProvidersSocial Worker 

No ID Information.


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