Healthcare Provider Details

I. General information

NPI: 1902747249
Provider Name (Legal Business Name): JULIET GRAY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2026
Last Update Date: 04/02/2026
Certification Date: 04/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 MAINE AVE
RICHMOND CA
94804-2736
US

IV. Provider business mailing address

3000 PARKER RD
RICHMOND CA
94806-2742
US

V. Phone/Fax

Practice location:
  • Phone: 510-231-1419
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number9917
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: