Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TH0004X | Health Psychologist | CA |
NPI | 1235897208 |
---|---|
Provider Name | Dr. Rebecca Greco |
First Address | San Diego, CA 92101-1767 |
Second Address | San Diego, CA 92101-1767 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/12/2021 |
Last Update Date | 07/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
123 | VETERAN AFFAIRS EMPLOYEE (01) | CA |