Channing Gredvig
Clinical Social Worker
3420 Kenyon St
San Diego
, California 92110-5001
Channing Gredvig
Clinical Social Worker
3420 Kenyon St
San Diego
, California 92110-5001
(619) 221-6556
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About
Features
Specialties
- Clinical Social Worker
Languages spoken
- English
Location
First Address
- Channing Gredvig
- 3420 Kenyon St
- San Diego, CA
- Zip : 92110-5001
- Fax : (619) 221-6556
- Phone : (619) 221-6550
Second Address
- Channing Gredvig
- 3420 Kenyon St
- San Diego, CA
- Zip : 92110-5001
- Fax : (619) 221-6556
- Phone : (619) 221-6550
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Where did Channing Gredvig do his residency?
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What type of doctor is Channing Gredvig
In what state does Channing Gredvig practice in?
Where is Channing Gredvig ’s practice located?
What is Channing Gredvig ’s gender?
Is Channing Gredvig a sole practitioner?
Is Channing Gredvig accepting new patients?
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Does Channing Gredvig offers telemedicine?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1041C0700X | Clinical Social Worker | 64651 | CA |
National Provider Identifier
| NPI | 1003113622 |
|---|---|
| Provider Name | Channing Gredvig |
| First Address | San Diego, CA 92110-5001 |
| Second Address | San Diego, CA 92110-5001 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 16/02/2011 |
| Last Update Date | 29/11/2021 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.