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General NPI Number Information
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NPI Number | 1285830372
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Entity Type | Individual
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Provider Name | JAMES MICHAEL GREGG PHD
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Gender | Male
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Dates
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Enumeration Date | 06/25/2007
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Last Update Date | 01/21/2022
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Provider Practice Location Address
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Address Line | 31625 HIGHWAY 101 S SALINAS VALLEY STATE PRISON
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City | SOLEDAD
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State | CA
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Zip | 93960-9529
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Country | US
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Telephone | 831-229-4880
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Fax |
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Provider Business Mailing Address
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Address Line | 5805 CHARLOTTE DR APT 393
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City | SAN JOSE
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State | CA
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Zip | 95123-3658
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Country | US
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Telephone | 415-244-7589
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 22436
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License Number State | CA
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