Healthcare Provider Details

I. General information

NPI: 1992051692
Provider Name (Legal Business Name): ALEXANDER FORREST GREER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2012
Last Update Date: 07/31/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8585 BLOSSOM LN.
SPRING VALLEY CA
91977
US

IV. Provider business mailing address

8585 BLOSSOM LN.
SPRING VALLEY CA
91977
US

V. Phone/Fax

Practice location:
  • Phone: 619-337-6100
  • Fax:
Mailing address:
  • Phone: 619-337-6100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: