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General NPI Number Information
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NPI Number | 1295617165
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Entity Type | Organization
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Legal Business Name | GROW PSYCHOLOGICAL ASSESSMENT AND COUNSELING SERVICES PC
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Dates
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Enumeration Date | 07/22/2025
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Last Update Date | 07/22/2025
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Provider Practice Location Address
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Address Line | 166 SANTA CLARA AVE STE 304
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City | OAKLAND
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State | CA
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Zip | 94610-1323
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Country | US
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Telephone | 510-681-4303
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Fax |
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Provider Business Mailing Address
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Address Line | 3316 MILDRED LN
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City | LAFAYETTE
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State | CA
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Zip | 94549-5424
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Country | US
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Telephone | 510-681-4303
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Fax |
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Authorized Official
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Title or Position | VP CUSTOMER SUCCESS
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Name | MIKE ATTIA
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Credential |
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Telephone | 858-449-7405
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number |
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License Number State |
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