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NPI Code Detail

MEDICARE: JAMES GRAY

MEDICARE: JAMES GRAY
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1942166525
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES GRAY
Provider Business Mailing Address
First Line : PO BOX 33568
Second Line :
City : SAN DIEGO
State : CA
Zip : 92163-3568
Country : US
Telephone Number : 855-223-7123
Fax Number : 855-223-7123
Provider Business Practice Location Address
First Line : 10015 LAKEWOOD DR SW
Second Line :
City : LAKEWOOD
State : WA
Zip : 98499-3838
Country : US
Telephone Number : 855-223-7123
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/29/2025
Last Update Date : 12/29/2025

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Directions to “ JAMES GRAY ” Practice Location

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