MEDICARE: JAMES ERIC GROSS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1013867928
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES ERIC GROSS

Provider Business Mailing Address
First Line	:	50 OCEAN ST.
Second Line	:
City	:	DAVENPORT
State	:	CA
Zip	:	95017-0000
Country	:	US
Telephone Number	:	831-425-7001
Fax Number	:

Provider Business Practice Location Address
First Line	:	50 OCEAN ST.
Second Line	:
City	:	DAVENPORT
State	:	CA
Zip	:	95017-0000
Country	:	US
Telephone Number	:	831-425-7001
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/30/2026
Last Update Date	:	01/30/2026

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Directions to “ JAMES ERIC GROSS ” Practice Location

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