Doctor Name: | JAMES MICHAEL GREGG |
NPI Number: | 1285830372 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PHD |
License Number: | 22436 |
Business Practice Address: | 31625 Highway 101 S Salinas Valley State Prison Soledad, CA - 939609529 |
Business Phone Number: | 8312294880 |
Business Fax Number: | |
Mailing Address: | 5805 Charlotte Dr Apt 393, SAN JOSE |
State: | CA |
Postal Code: | 951233658 |
Phone Number: | 4152447589 |
Fax Number: | |
NPI Enumeration Date: | 06/25/2007 |
NPI Last Update Date: | 12/08/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 22436 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |