Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | ||
N | 101YM0800X | Mental Health Counselor | 83897 | CA |
NPI | 1003207317 |
---|---|
Provider Name | Ashley Gregory |
First Address | Hayward, CA 94541-4028 |
Second Address | Hayward, CA 94541-4028 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/02/2015 |
Last Update Date | 08/11/2018 |