Healthcare Provider Details

I. General information

NPI: 1811689953
Provider Name (Legal Business Name): GREYCE KELLE DIAS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2023
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3208 ROSEMEAD BLVD STE 100
EL MONTE CA
91731-2830
US

IV. Provider business mailing address

1091 DOROTHEA RD
LA HABRA HEIGHTS CA
90631-8113
US

V. Phone/Fax

Practice location:
  • Phone: 626-961-8971
  • Fax:
Mailing address:
  • Phone: 732-677-0359
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberASW113071
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW141666
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: