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General NPI Number Information
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NPI Number | 1265082069
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Entity Type | Individual
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Provider Name | MEGAN A GRAY PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 09/13/2019
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Last Update Date | 02/24/2022
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Provider Practice Location Address
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Address Line | 30 N ROOSEVELT AVE
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City | PASADENA
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State | CA
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Zip | 91107-3621
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Country | US
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Telephone | 760-459-7912
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Fax |
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Provider Business Mailing Address
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Address Line | 19712 MACARTHUR BLVD STE 110
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City | IRVINE
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State | CA
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Zip | 92612-2407
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TH0004X
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Taxonomy Name | Health Psychologist
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License Number | PSY30742
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY30742
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License Number State | CA
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